About Pericarditis (Pericardial Inflammation)

Overview

Pericarditis is the inflammation of the pericardium, which is the sac surrounding the heart. The pericardium is made up of two thin layers of tissue with a small amount of fluid between them. This fluid helps prevent friction between the layers. Pericarditis can be acute, subacute, chronic, or recurrent, depending on how long it lasts. Acute pericarditis occurs suddenly and does not last long. Subacute pericarditis occurs within weeks or a few months after the initial event that caused it. Chronic pericarditis lasts for a longer period of time. Recurrent pericarditis refers to repeated episodes of pericarditis. In some cases, pericarditis can lead to a buildup of fluid in the sac around the heart, known as a pericardial effusion. This can potentially affect the heart's ability to pump blood properly and become life-threatening if left untreated.

Causes and Risk Factors

The causes of pericarditis include:

• Infections: Fungal, viral, or bacterial infections can lead to pericarditis.
• Heart inflammation: Pericarditis can develop as a result of heart inflammation due to surgery or a heart attack.
• Autoimmune disorders
• Injury or trauma
• Chronic stress

The non-modifiable risk factors of pericarditis are factors that cannot be changed. These include:

• Age: Increasing age is a risk factor for pericarditis.
• Genetic predispositions: Having a positive family history of pericarditis or related conditions can increase the risk.

The modifiable risk factors of pericarditis are factors that can be influenced or changed. These include:

• Poor dietary habits: Unhealthy eating patterns can contribute to the development of pericarditis.
• Low physical activity: Lack of exercise can be a modifiable risk factor for pericarditis.
• Lifestyle factors: Certain cultural and social factors can influence the risk of pericarditis.

It is recommended to maintain a healthy weight, engage in regular physical activity, and follow a healthy diet to reduce modifiable risk factors. Remember to consult with your healthcare professional for personalized advice.

Symptoms

The most common early symptoms of pericarditis include:

• Sharp, stabbing chest pain that is usually on the left or in the middle of the chest.
• Pain that may radiate to the neck and shoulders
• Pain that feels worse when breathing deeply and is improved by sitting up and leaning forward.
• Low-grade fever or congestion

As pericarditis progresses or becomes more severe, additional symptoms may occur:

• Fatigue
• Shortness of breath
• Nausea
• Coughing
• Weakness
• Heart palpitations
• Edema (swelling in the legs, ankles, feet, and belly)
• Low blood pressure

Remember that these symptoms can vary depending on the cause and severity of pericarditis. It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment.

Diagnosis

Common examinations, tests, and procedures performed to diagnose pericarditis include:

• Electrocardiogram (EKG): This test records the electrical activity of the heart and can detect abnormal patterns associated with Pericarditis.
• Chest X-ray: This imaging test can help visualize the heart and surrounding structures for any signs of inflammation or fluid buildup.
• Echocardiogram: This painless scan uses sound waves to produce detailed images of the heart and can identify abnormalities in the pericardium.
• Blood tests: These tests measure inflammation markers and can help determine if there is an underlying infection or autoimmune disease.

Additional examinations, tests, and procedures to determine the stage or severity of pericarditis may include:

• Aspiration of pericardial fluid: If a pericardial effusion is present, a sample of the fluid may be removed for laboratory analysis.
• Skin or blood test for tuberculosis: This test helps identify if tuberculosis is the cause of pericarditis.
• Advanced imaging tests such as magnetic resonance imaging (MRI) or computed tomography (CT) scan: These tests provide detailed images of the heart's structure and can confirm a diagnosis or assess complications.

It's important to note that these are general descriptions, and specific diagnostic approaches may vary depending on individual circumstances. Always consult with your healthcare provider for accurate diagnosis and treatment recommendations.

Treatment Options

The goals of treatment for pericarditis are:

• Eliminating and controlling the spread of bacteria
• Relieving pressure from fluid buildup around the heart
• Preventing remodeling of the heart

Other treatments and health behavior changes may include:

• Rest and gradual rehabilitation: Recovery from pericarditis can take time, so it's important to rest and gradually return to normal activities.
• Antibiotics: Isoniazid, rifampin, pyrazinamide, and ethambutol, are commonly prescribed to eliminate the bacteria causing the infection.
• Pain relief and inflammation medications: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or high-dose aspirin can provide relief. Colchicine is an inflammation-reducing drug that minimizes symptom duration and prevents recurrences.
• Corticosteroids: These medications lower inflammation but are generally used only if NSAIDs are ineffective or not tolerated.
• Surgery (pericardiectomy): In severe cases or recurrent pericarditis that doesn't respond to other treatments, surgical removal of the pericardium may be necessary.
• Pericardiocentesis: This is a procedure that removes excess fluid from the pericardium using a thin needle guided by imaging. This helps relieve pressure on the heart.

Remember, treatment plans should be discussed with a healthcare professional as they can vary depending on individual circumstances. Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.