Summary about Disease
Pericarditis is inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This inflammation can cause chest pain and other symptoms. In many cases, it's mild and resolves on its own, but severe cases can require treatment and, rarely, can lead to serious complications.
Symptoms
Sharp, stabbing chest pain, often worsened by breathing in deeply, coughing, or lying down. The pain may radiate to the left shoulder and neck.
Aching chest pain.
Shortness of breath, especially when lying down.
Heart palpitations.
Fatigue.
Mild fever.
Cough.
Abdominal or leg swelling.
Causes
Viral Infections: The most common cause.
Bacterial Infections: Less common.
Fungal Infections: Rare.
Autoimmune Disorders: Lupus, rheumatoid arthritis, scleroderma.
Kidney Failure: Uremia.
Heart Attack: Post-myocardial infarction pericarditis (Dressler's syndrome).
Injury: Trauma to the chest.
Cancer: Tumors affecting the pericardium.
Certain Medications: Procainamide, hydralazine, isoniazid, phenytoin, warfarin.
Radiation Therapy: To the chest.
Idiopathic: In many cases, the cause is unknown.
Medicine Used
Pain Relievers: Aspirin or ibuprofen (NSAIDs) to reduce pain and inflammation.
Colchicine: An anti-inflammatory drug often used in combination with NSAIDs to reduce inflammation and prevent recurrence.
Corticosteroids (Prednisone): Used if NSAIDs and colchicine are ineffective or contraindicated, but long-term use has risks.
Antibiotics, Antifungals: Used if the pericarditis is caused by a bacterial or fungal infection.
Specific Medications: Treatment of underlying conditions like autoimmune disorders or kidney failure.
Is Communicable
Pericarditis itself is not communicable. However, if the pericarditis is caused by a viral or bacterial infection, the underlying infection may be communicable.
Precautions
Good Hygiene: If the cause is a communicable infection, practice good hygiene (handwashing) to prevent its spread.
Rest: Adequate rest is important for recovery.
Avoid Strenuous Activity: Limit physical exertion until cleared by a doctor.
Follow Doctor's Instructions: Adhere to the prescribed medication regimen and follow-up appointments.
Report Worsening Symptoms: Seek immediate medical attention if chest pain worsens or new symptoms develop.
How long does an outbreak last?
Acute pericarditis typically lasts for a few weeks to a few months.
Recurrent pericarditis can have episodes lasting for weeks or months, with periods of remission in between.
Chronic pericarditis lasts longer than three months.
How is it diagnosed?
Physical Exam: Listening for a pericardial friction rub (a scratching sound).
Electrocardiogram (ECG or EKG): To detect characteristic changes in heart rhythm.
Echocardiogram: An ultrasound of the heart to assess heart function and detect fluid around the heart (pericardial effusion).
Chest X-ray: To evaluate the size and shape of the heart and lungs.
Cardiac MRI or CT Scan: To visualize the pericardium and heart in detail.
Blood Tests: To check for inflammation markers (e.g., CRP, ESR), infection, kidney function, and autoimmune disorders.
Pericardiocentesis: (Rarely) Removal of fluid from the pericardial sac for analysis.
Timeline of Symptoms
Initial Stage: Sudden onset of sharp chest pain, often worsening with breathing or lying down.
Acute Phase: Continued chest pain, possibly with shortness of breath, fever, and fatigue. This phase can last for several days to weeks.
Recovery Phase: Gradual improvement in symptoms with treatment and rest. This can take weeks or months.
Recurrence (if applicable): Symptoms return after a period of improvement.
Chronic (if applicable): Symptoms persist for more than three months.
Important Considerations
Cardiac Tamponade: A serious complication where fluid buildup in the pericardium compresses the heart, impairing its ability to pump. This requires immediate treatment.
Constrictive Pericarditis: A long-term complication where the pericardium becomes thickened and scarred, restricting heart function. This may require surgery.
Ruling out other conditions: It's important to rule out other causes of chest pain, such as heart attack or pulmonary embolism.
Individual Variability: The severity and duration of pericarditis can vary significantly from person to person.
Follow-up: Regular follow-up with a cardiologist is crucial to monitor for complications and manage recurrent pericarditis.