Summary about Disease
Viral pericarditis is an inflammation of the pericardium, the sac-like membrane surrounding the heart. It is most commonly caused by viral infections. The inflammation can cause chest pain and other symptoms. In many cases, viral pericarditis resolves on its own or with supportive care. However, complications can occur, requiring further treatment.
Symptoms
Sharp, stabbing chest pain (often worse with deep breathing, coughing, or lying down)
Pain may radiate to the shoulder, neck, or back
Shortness of breath
Fatigue
Low-grade fever
Cough
Heart palpitations
Causes
The most common cause is viral infection. Viruses include:
Coxsackievirus
Echovirus
Adenovirus
Influenza virus
Epstein-Barr virus (EBV)
Cytomegalovirus (CMV)
Herpes simplex virus (HSV)
Human Immunodeficiency Virus (HIV)
Medicine Used
Pain relievers: NSAIDs (Nonsteroidal anti-inflammatory drugs) like ibuprofen or aspirin are often used to reduce pain and inflammation.
Colchicine: An anti-inflammatory medication often used in conjunction with NSAIDs to reduce inflammation and prevent recurrence.
Corticosteroids: (e.g., Prednisone) May be used in cases where NSAIDs and colchicine are not effective or are contraindicated, but are typically avoided due to potential side effects and increased risk of recurrence.
Analgesics: Additional pain relievers may be used for pain management.
In rare cases, if a specific viral infection is identified and treatable, antiviral medications might be considered.
Is Communicable
Viral pericarditis itself is not directly communicable. However, the underlying viral infections that cause it are communicable. Whether a person becomes infected with the virus and then develops pericarditis depends on several factors, including their immune system and the specific virus.
Precautions
Precautions depend on the underlying viral infection:
Good hygiene: Frequent handwashing with soap and water.
Avoid close contact: Limit close contact with people who are sick.
Cover coughs and sneezes: Use a tissue or your elbow.
Vaccination: Get vaccinated against preventable viral illnesses like influenza.
Avoid sharing personal items: Don't share utensils, drinks, or towels.
How long does an outbreak last?
The duration of viral pericarditis can vary.
Acute pericarditis: Typically lasts for a few weeks (1-3 weeks).
Recurrent pericarditis: Can involve repeated episodes over months or even years.
How is it diagnosed?
Physical exam: Listening to the heart for a pericardial rub (a grating sound).
Electrocardiogram (ECG/EKG): To detect characteristic changes associated with pericarditis.
Echocardiogram: Ultrasound of the heart to assess heart function and detect fluid buildup (pericardial effusion).
Chest X-ray: To rule out other conditions like pneumonia.
Blood tests: To look for signs of inflammation (e.g., elevated CRP, ESR), cardiac enzyme levels (to rule out heart attack), and possibly viral testing (though identifying the specific virus is not always necessary or possible).
Cardiac MRI: Sometimes used for better visualization of the pericardium and to detect inflammation or complications.
Timeline of Symptoms
The timeline can vary, but a general progression is:
Initial infection: Exposure to the virus (may or may not have other symptoms).
Prodromal phase (days): May experience flu-like symptoms (fever, fatigue, muscle aches).
Acute phase (days to weeks): Development of chest pain, shortness of breath, and other symptoms of pericarditis.
Recovery phase (weeks to months): Gradual improvement of symptoms. Symptoms can last between 1 to 3 weeks and can recur.
Important Considerations
Differentiation from other conditions: Chest pain can be a symptom of many conditions, including heart attack. It's important to seek prompt medical attention to rule out more serious causes.
Complications: While most cases resolve without complications, potential complications include:
Pericardial effusion (fluid buildup around the heart)
Cardiac tamponade (pressure on the heart from fluid buildup)
Constrictive pericarditis (thickening and scarring of the pericardium)
Recurrence: Pericarditis can recur, even after successful treatment. Following medical advice and completing the prescribed course of medication are important to minimize the risk of recurrence.
Activity Restrictions: It is very important to limit activity to avoid exacerbating symptoms and to avoid potential complications, such as heart rhythm problems.
Follow-up: Regular follow-up with a healthcare provider is important to monitor progress and detect any potential complications.