Summary about Disease
Fibrinous pericarditis is an inflammation of the pericardium (the sac surrounding the heart) characterized by the deposition of fibrin. Fibrin is a protein involved in blood clotting, and its presence in the pericardial space leads to a "shaggy" or "bread and butter" appearance. This condition is a common manifestation of pericarditis, often associated with chest pain and a pericardial friction rub.
Symptoms
Sharp, stabbing chest pain, often worsened by breathing, coughing, swallowing, or lying down. The pain may radiate to the shoulder, back, or neck.
Pericardial friction rub (a scratching or grating sound heard with a stethoscope)
Fever
Malaise (general feeling of discomfort, illness, or unease)
Fatigue
Shortness of breath (dyspnea)
Causes
Infections: Viral infections (most common), bacterial infections, fungal infections, and parasitic infections.
Autoimmune diseases: Systemic lupus erythematosus (SLE), rheumatoid arthritis, scleroderma.
Uremia (kidney failure): Build-up of toxins in the blood.
Post-myocardial infarction (Dressler's syndrome): Occurs after a heart attack.
Cancer: Metastatic cancer, lymphoma, leukemia.
Trauma: Injury to the chest.
Radiation therapy: To the chest area.
Drug-induced: Certain medications can cause pericarditis.
Idiopathic: In some cases, the cause is unknown.
Medicine Used
Pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or indomethacin are commonly used to reduce pain and inflammation.
Colchicine: An anti-inflammatory drug often used in conjunction with NSAIDs to reduce inflammation and prevent recurrence.
Corticosteroids: Prednisone may be used if NSAIDs and colchicine are ineffective or contraindicated, but are often avoided due to potential side effects and increased risk of recurrence.
Antibiotics/Antifungals/Antivirals: If the pericarditis is caused by a bacterial, fungal, or viral infection, appropriate antimicrobial medications will be prescribed.
Is Communicable
Fibrinous pericarditis itself is not communicable. However, if the underlying cause is an infectious agent (e.g., a virus), then the *infection* may be communicable. The pericarditis is a result of the infection, not the infection itself.
Precautions
Precautions depend on the underlying cause of the fibrinous pericarditis.
If due to infection: Follow standard hygiene practices like frequent handwashing, covering coughs and sneezes, and avoiding close contact with others while symptomatic.
If due to autoimmune disease: Follow the management plan prescribed by your doctor for your specific autoimmune condition.
General: Avoid strenuous activity until cleared by a doctor. Follow medication instructions carefully. Attend all follow-up appointments.
How long does an outbreak last?
The duration of a fibrinous pericarditis episode can vary depending on the underlying cause and the effectiveness of treatment. It can last from a few days to several weeks. Recurrent pericarditis can prolong the overall duration of the illness.
How is it diagnosed?
Physical Exam: Listening for a pericardial friction rub with a stethoscope.
Electrocardiogram (ECG/EKG): May show characteristic changes associated with pericarditis.
Echocardiogram: Ultrasound of the heart to assess for pericardial effusion (fluid around the heart) and rule out other cardiac conditions.
Chest X-ray: To evaluate the size and shape of the heart and lungs.
Blood tests: To check for markers of inflammation (e.g., ESR, CRP), cardiac enzymes (to rule out a heart attack), and to identify possible underlying causes (e.g., kidney function tests, autoimmune markers).
Pericardiocentesis: In some cases, a sample of fluid from the pericardial sac may be removed and analyzed to identify the cause of the pericarditis (e.g., infection, cancer).
Timeline of Symptoms
The timeline can vary significantly. A typical course might involve:
Onset: Sudden or gradual onset of chest pain.
Early phase: Chest pain worsening with breathing or lying down, potentially accompanied by fever and malaise. Pericardial friction rub may be audible.
Acute phase: Pain persists, potential development of pericardial effusion. Symptoms may fluctuate in intensity.
Resolution: With treatment, symptoms gradually improve over days to weeks. However, recurrence is possible, leading to a return of symptoms.
Important Considerations
Cardiac Tamponade: A serious complication of pericarditis, especially if a large pericardial effusion develops. This occurs when the fluid around the heart compresses the heart, preventing it from filling properly. Symptoms include shortness of breath, lightheadedness, and low blood pressure. This is a medical emergency.
Constrictive Pericarditis: A rare but serious complication in which the pericardium becomes thickened and scarred, restricting the heart's ability to expand. This can lead to symptoms of heart failure.
Ruling out other conditions: It's crucial to rule out other causes of chest pain, such as a heart attack or pulmonary embolism.
Follow-up: Close follow-up with a doctor is essential to monitor for complications and ensure effective treatment.