Can Exercise Help Pericarditis?
Can Exercise Help Pericarditis?
Exercise, in general, is good for overall wellbeing of a person. Regular exercise has several health benefits, such as improving cardiovascular activity, boosting energy, reducing stress, increasing immunity and prolonging life in general. Exercise helps maintain a healthy body, but what if our body is not healthy and fit to exercise? Will exercise then help the person? The answer is sometimes yes and sometimes no.
Pericarditis, as we all know, is the “inflammation of pericardium”, the layer that surrounds our heart. Inflammation has five cardinal signs i.e., rubor (redness), tumor (swelling), calor (heat), dolor (pain) and functio laesa (loss of function). It means that our body is fighting an infection and indicates that body is in a diseased state. When in diseased state, the body requires rest, time to heal which means avoiding exercise.
This simply means that when in active pericarditis it is best to rest. If we continue to exercise and exhaust our body; not pay heed to the signals of our body then there might be exacerbation of symptoms and pericarditis might worsen.
Pericarditis presents as acute (symptoms subside within a month), incessant (symptoms last for more than 4-6 weeks, but less than 3 months), chronic (symptoms last for more than 3 months and/or recurrent (symptoms recur after the infection has subsided).
Pericarditis is mostly idiopathic or viral in nature and some cases are bacterial or fungal in nature and these are treated accordingly. It is mostly treated with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to reduce the inflammation and swelling. Some cases might require treatment with colchicine or steroid and also surgical intervention when severe. Non-pharmocological treatment is to rest and restrict physical activity.
What if you Continue to Exercise in Pericarditis?
There are basically two metabolic reactions in our body, anabolic reaction and catabolic reaction. Anabolic reaction is the one in which there is build up of molecules in our body and restoration of energy while catabolic reaction is the breakdown of molecules to release energy. Exercise demands catabolic reaction in our body, so does pericarditis. Exercise might exacerbate inflammatory response and in the process might prolong the inflammation. In pericarditis, the body is healing and if we do not rest and restrict physical activity our body will require more time to heal. We need to restrict physical activity in order to heal faster. Continued exercise may also lead to progression of symptoms and make them refractory (resistant to treatment).
The impact of continued exercise in pericarditis can be grave. It can lead to complication such as myocarditis (inflammation of myocardium), which increases the risk of sudden cardiac death. There are also other complications such as worsening of pericardial effusion, cardiac tamponade, constrictive pericarditis or refractory/recurrent pericarditis. These complications might require prolonged treatment or surgical intervention, so it is best to avoid these complications by resting and restricting physical activity until the active pericarditis has completely resolved.
It is better to check whether pericarditis has resolved or not. When resolved there will be no symptoms of chest pain, fever, shortness of breath and other symptoms of fatigue and exhaustion. Also diagnostics will rule out pericardial effusion with baseline and normal ESR (erythrocyte sedimentation rate), CBC (complete blood count) and/or CRP (C Reactive Protein).
Pericarditis is itself a common inflammatory condition that affects the pericardium and has numerous infective and non-infective causes. It is recommended that intense physical activity should be avoided to heal faster and to avoid progression of inflammation and also to avoid further complications. Exercising helps maintain a healthy body, but avoiding it in active pericarditis is the right health choice to make. There are ongoing studies in this topic, and all direct toward avoiding strenuous physical activity in pericarditis. The evidence to support this recommendation is; however, limited and further evidences and studies will help better understand the impact of exercise on pericarditis, but until then it is best to avoid strenuous exercise in pericarditis and rest the body.