What is Pericarditis?
Pericarditis is a pathological condition in which there is inflammation of the pericardium, which covers the heart about its perimeter. Inflammation of the pericardium generally causes chest pain along with a variety of other symptoms. This pain arises when the inflamed layers of the pericardium start rubbing against each other.
Pericarditis usually is a condition which is pretty much short lived, but it can become chronic with continued symptoms for a prolonged period of time. Majority of cases of Pericarditis resolve on their own without any need for any specific treatment. In cases where Pericarditis becomes chronic, then medications, and in rare cases surgery, may be required to treat the condition. The earlier Pericarditis is diagnosed the better are the chances of preventing complications.
What Causes Pericarditis?
Normally, the heart is enveloped by a layered sac like membrane which has a lubricating fluid. The function of this membrane is to protect the heart. Pericarditis develops when there is inflammation of this membrane causing chest pain and other symptoms. It is extremely difficult to identify a clear cause for Pericarditis. but studies point to a viral cause for development of Pericarditis. A major heart attack can also result in development of Pericarditis due to the damaged heart muscles resulting in inflammation.
Some of the other causes of Pericarditis are:
- Systemic inflammatory disorders like lupus or rheumatoid arthritis
- Trauma to the heart or chest area
- Other medical conditions like kidney dysfunction or cancer
What Are The Symptoms Of Pericarditis?
The classic presenting feature of Pericarditis is an excruciating stabbing chest pain in the left side of the chest. This pain may radiate to the left shoulder and neck region. This pain usually will worsen with any act of cough or sneeze or with deep breath. Sitting and leaning forwards tends to ease the pain up. Some of the other symptoms of Pericarditis are:
- Dyspnea when in a reclined position
- Heart palpitations
- Mild fever
- Excessive fatigue
- Cough
- Abdominal swelling
- Swelling of the lower extremities
How Is Pericarditis Diagnosed?
To begin with, the treating physician will take the patient’s detailed history including whether there is any family history of cardiac issues and the duration of the symptoms. If there is inflammation of the heart suspected then the following tests will be ordered to confirm the diagnosis:
Electrocardiogram: This test shows the heartbeat in the form of electrical impulses. This test can show whether there is any abnormality in the rhythm of the heart and whether the heart is functioning normally.
Echocardiogram: This test makes use of ultrasound waves to look at the functioning of the heart. This test can accurately identify any abnormality of the functioning of the heart.
Chest X-ray: A chest x-ray may be taken to identify any areas of inflammation within the heart and around the chest area.
CT and MRI scan: These images will accurately show whether there is any inflammation present in and around the heart. This study is more accurate than normal x-rays images.
How Is Pericarditis Treated?
The treatment for Pericarditis will depend on the actual cause of the condition and how severe is the inflammation. If the inflammation is mild, then it will resolve on its own with time and no specific treatment is required for it. If the inflammation is somewhat severe it can be treated with medication management and in some cases also with surgery.
Medications: Medications that will be prescribed will include those which will reduce inflammation and ease up the pain. To begin with, pain medications like Tylenol or ibuprofen will be given to calm down the inflammation and ease up the pain symptoms. Once starting the course there should be symptom improvement noted with a day or two and in majority of the cases this is the only treatment in the form of medications that may be required for treating Pericarditis.
Apart from this, medication like colchicine can also be given to calm down the inflammation that is acute in nature. Colchicine also helps in preventing future Pericarditis as well. It should be noted here that this medication is contraindicated for people who have preexisting kidney problems or are on other medications. The patient should make sure to tell the physician about the medications that he or she is taking before starting this drug.
If pain medications and colchicine are not effective in relieving the symptoms then steroids can also be used as a form of treatment for Pericarditis. Usually the acute form of Pericarditis lasts for a few weeks but there is always a chance of recurrence. Antibiotics will be required for treatment of Pericarditis if a bacterial source is found to be causing it.
Surgery: This is only reserved if a patient develops complications due to Pericarditis.
Pericardiocentesis: One such complication of pericarditis is a cardiac tamponade in which there is a buildup of fluid around the heart. This condition is treated by a procedure called as pericardiocentesis. In this procedure, a catheter is inserted into the affected area and the fluid surrounding the heart is drained. This procedure is done under a local anesthetic. This procedure is done in an inpatient setting as it requires quite a few days to drain all the fluid from the heart.
Pericardiectomy: This procedure is done when the pericardium becomes extremely rigid and makes it tough for the heart to function. In this procedure the entire pericardium is taken out.
What Are The Measures To Be Taken For An Individual With Pericarditis?
In mild cases of Pericarditis, just plenty of rest and over the counter pain medications are enough. During the healing phase try and not do any strenuous activity and let the heart heal. Consult the doctor before starting any type of exercise once you have recovered from Pericarditis.
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