Pericarditis, as we all know, is the inflammation of pericardium, the layer that surrounds our heart. Generally, inflammation has five classic signs i.e., rubor (redness), 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 strenuous activity or work.
Pericarditis presents in acute form in which symptoms subside within a month; incessant form in which symptoms last for more than 4 to 6 weeks, but less than 3 months; chronic form in which the symptoms last for more than 3 months and/or recurrent form in which the symptoms recur after the initial infection has subsided.
Pericarditis is mostly idiopathic, but it can have viral, bacterial or fungal etiology, which are treated accordingly. It is mostly treated with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to reduce the pain and swelling. Some cases might require treatment with colchicine or steroid and sometimes surgical intervention when it becomes severe and is not controlled with the conventional treatment. Non-pharmocological treatment is to rest and restrict physical activity.
Can I Work With Pericarditis?
What if you continue to do strenuous work? 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. Physical activity demands catabolic reaction in our body and so does pericarditis. Extreme activity 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 or strenuous activity may also lead to progression of symptoms and make them refractory (resistant to treatment).
The impact of continued strenuous activity in pericarditis can have grave results. 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.
When resolved there will be no symptoms of chest pain, fever, shortness of breath and other symptoms of fatigue and exhaustion. In addition, diagnostics will rule out pericardial effusion with baseline and normal ESR (erythrocyte sedimentation rate), CBC (complete blood count) and/or CRP (C Reactive Protein).
It is recommended that intense physical activity should be avoided to heal faster and to avoid progression of inflammation in order 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 especially in athletes.
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. Although, it is okay to continue day-to-day work, which does not exhaust the body and increase/worsen symptoms of pericarditis, and a person can go to regular work that does not require any strenuous activity. The individual should continue to take their medications and complete the course of medications. Strenuous activity or gym should be started slowly after the resolution of pericarditis, which does not exhaust the body.
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