Pericarditis Symptoms and Treatments

Pericarditis is a common medical disorder and usually presents with chest pain. The heart is surrounded by a thin fibrous lining called the pericardium. Sometimes this lining can get inflamed or infected and this is known as pericarditis.

Pericarditis can present with chest pain, low grade fever and general malaise. The pain is often sharp and worsens when one lies down. The sharp pain is often felt right behind the left nipple or underside of the ribs. Sometimes the pain many be a dull ache and often confused with angina. Other features of pericardial pain include worsening intensity with deep breathing and exercise. The pain is often less when sitting up and leaning forward. When pericarditis is long standing it may also be accompanied by accumulation of fluid around the heart known as pericardial effusion. This is often painless but shortness of breath is quite prominent.

There are many causes of pericarditis. The most common is a heart attack which causes irritation of the pericardium. Post heart attack pericarditis often lasts a few weeks and is easily treated. Other caused of pericarditis include:

Rheumatoid arthritis, lupus
Trauma to the heart, example blunt trauma to the chest
Kidney failure, AIDs, tuberculosis,
Various cancers
Medications
Bacterial infections
Post open heart surgery
Viral pericarditis may occur in younger individuals

When pericarditis is left untreated two complications can develop:

Constrictive pericarditis: in this case the long term irritation of pericardium leads to thickening and scarring of the pericardium which starts to constrict the heart. The heart in turn can no longer pump well and this results in swelling of the feet, abdomen and neck. Most people become very short of breath when this complication develops.

The other feared complication of pericarditis is cardiac tamponade. The chronic inflammation leads to fluid accumulation around the heart which compresses the heart. The heart can no longer pump effectively and can be fatal if the fluid in the pericardium is not removed promptly.

The diagnosis of pericarditis include a history and listening to the heart. Other tests usually performed include an ECG, chest x ray, Echocardiogram CT scan or an MRI.

The treatment of acute pericarditis is usually bed rest and medications. Most people start to feel better after a short course of non steroidal anti inflammatory drugs. Sometimes corticosteroids may be needed for a few weeks. Acute pericarditis typically lasts several weeks but sometimes can last a few months. Bacterial pericarditis usually needs to be treated with antibiotics and drainage.

If there is fluid around the heart, it may be drained with a needle using ultrasound or may require surgery. In cases of constrictive pericarditis, the surgeon may need to open the chest and remove the thick fibrous lining to prevent compression on the heart.

Viral pericarditis is treated with aspirin like drugs and usually follows a benign course. The majority of cases of pericarditis usually heal without any sequelae.