Pericarditis: Symptoms, Diagnosis & Treatment

Overview

Pericarditis can cause irritation and swelling of the thin sac-like tissue around the heart (pericardium). Pericarditis frequently causes severe chest pain, and occasionally other signs. The chest pain happens because the irritating parts of the pericardium press one another.

Pericarditis is typically mild and disappears without treatment. Treatment for more severe cases can consist of medication and, in rare instances surgical intervention. Early diagnosis and treatment can lower the chance of complications that can last for a long time from pericarditis¹.

 

Symptoms of Pericarditis

It is the single most frequent sign of the condition known as pericarditis. It typically feels sharp chest pain. Some people experience the sensation of achy, dull, or chest pain that is similar to pressure.

• The pain typically occurs behind the breastbone, or on the left chest side.
• It could spread across your left shoulder and neck.
• It can get much worse when coughing lay down, or lie down, or take an exhale.
• Leaning forward and sitting upright helps you feel more relaxed.

Other symptoms and signs of pericarditis are:

• Leg swelling or abdominal swelling
• Cough
• General sensation of weakness or sick
• Low-grade fever
• Heartbeats that race or beat (heart palpitations)
• Breathlessness when lying down

The symptoms you experience depend on the kind of pericarditis that you suffer from. Pericarditis is classified into various categories based on the symptoms that are present and the length of time that symptoms last.

• Acute Pericarditis is sudden but does not last more than three weeks. It is possible that future episodes will be observed. It can be difficult to distinguish between acute pericarditis as well as pain caused by an attack on the heart.
• Recurrent Pericarditis is usually seen between four and six weeks following an acute episode of pericarditis, with no symptoms between.
• Pericarditis that is constant can last from four to six weeks but is less than three months. The symptoms are constant.
• Chronic Pericarditis that is constricting typically is not as severe and can last for more than three years.

When should you seek medical help?

Take immediate medical attention If you notice new signs of chest discomfort.

The symptoms of pericarditis are comparable to other lung and heart conditions. The sooner you’re assessed, the faster you will receive an appropriate assessment and therapy. For instance, while the cause of chest pain could be due to pericarditis in origin, the actual reason could be an incident of heart disease or blood clot that has formed in the lung (pulmonary embolus).

Causes

Pericarditis cause is not always clear. Sometimes, doctors are unable to pinpoint the reason (idiopathic pericarditis).

Pericarditis causes are:

• A heart attack or  surgical procedure, which may trigger the occurrence of delayed pericarditis or pericarditis (Dressler’s syndrome, also known as postcardiac damage syndrome)
• Infection
• Inflammatory disorders that are systemic, including lupus and Rheumatoid arthritis
• trauma, like injury or damage to the chest or your heart in the course of an automobile or another incident
• Other health issues, including kidney failure, AIDS, tuberculosis and cancer

Complications

Early detection and treatment for pericarditis is usually a way to reduce the risk of complications that can last for a long time. The most common complications of pericarditis are:

Pericardial effusion. Pericarditis is usually caused by fluid in the heart and can result in more severe complications.

Constrictive chronic pericarditis. Some people with chronic (chronic) pericarditis experience permanent scarring and thickening of the pericardium. This hinders it from fully filling up and completely emptying. This uncommon complication usually leads to significant constriction of legs as well as the abdomen, as well as shortness of breath.

The tamponade of the cardiac valve. This life-threatening condition is caused by excessive fluid accumulating inside the pericardium. The excess fluid causes immense pressure upon the heart but doesn’t let it fill up properly. The heart’s blood supply is reduced which causes a drastic reduction in blood pressure. Cardiac tamponade is a condition that requires immediate treatment.

Diagnosis

The doctor will inspect you and ask questions regarding your medical history and symptoms.

During the examination, the doctor will put the stethoscope over your chest and listen to the heart’s sounds. Pericarditis produces a particular sound known as the pericardial rub. The sound occurs when two sacs around the heart (pericardium) rub against one and against each.

 

The blood tests are typically done to determine the presence of heart attacks inflammation and infection. Other tests to determine the presence of pericarditis include:

• Electrocardiogram (ECG). An electrocardiogram is a fast and painless test that captures the electrical signals that are generated in your heart. The sticky patch (electrodes) is equipped with cables connected to connect to an electronic monitor. They record electrical signals that cause your heart beat. A computer stores the information and displays it in waves on a screen or printed on paper.
• Chest Xray. A chest X-ray could reveal changes in the dimensions and shapes of the heart. The images could show an increased heart size in the event that fluid is accumulating within the pericardium.
• Echocardiogram. Sound waves (ultrasound) produce images of the heart’s movement. The doctor may use this test to assess how your heart is pumping blood and whether there is any fluid accumulation within the pericardium.
• The Cardiac Computerized Tomography (CT) scanning. Cardiac CT scans make use of X-rays to produce images of your chest and heart. The test is used to detect an increase in thickness that could be an indication of constrictive pericarditis. The doctor might recommend the exam to determine any other reasons for sudden chest discomfort, for instance, the presence of a blood clot within a lung (pulmonary embolus) or the rupture of your aorta (aortic dissection).
• Cardiac Magnetic Resonance Imaging (MRI). Cardiac MRI utilizes a magnetic field and radio waves to generate cross-sectional pictures of your heart that may reveal inflammation, thickening or other changes within the pericardium.

 

Treatment of Pericarditis

Treatment for pericarditis varies based on the source and extent of the symptoms. Mild pericarditis can improve without treatment.

Medications

Treatments to lessen swelling and inflammation are commonly prescribed. Examples include:

• Pain relief medications. Pericarditis pain can typically be treated with over-the-counter painkillers, like Ibuprofen or aspirin (Advil, Motrin IB, other). Prescription-strength pain relievers also may be used.
• Colchicine (Colcrys, Mitigare). This drug decreases inflammation within the body. It’s prescribed to treat acute pericarditis, or the symptoms of which tend to return. Do not use this medication when you suffer from kidney or liver problems. Colchicine could also cause problems with other medications. Your doctor will be sure to check your medical history prior to giving you colchicine.
• Corticosteroids. Corticosteroids are strong drugs that combat inflammation. Your doctor might prescribe a corticosteroid like prednisone if you do not improve with other treatments or if your symptoms continue to recur.

If the pericarditis you’re experiencing is the result of an infection with bacteria You’ll be treated by using antibiotics and drainage should it be necessary.

Surgery or other procedures

If pericarditis results in fluid buildup in the area around your heart, you could require a drainage procedure or even surgery. Treatment options can include:

• Pericardiocentesis. In this procedure, the doctor will use the sterile needle, or tiny tubing (catheter) to drain and remove all excess fluid out of the pericardial chamber. You’ll be administered numbing medicine (local anaesthetic) prior to the procedure. The doctor will use an echocardiogram and ultrasound to direct the tube and needle to the right place in the body. The drain remains on the body for a number of days during your stay in hospital.
• Pericardiectomy. This surgery removes the entire pericardium. It can be performed in the event that the sac around the heart is rigid due to constrictive pericarditis.

 

Lifestyle and home solutions to home

For mild pericarditis and pain medication over-the-counter that, you take according to the advice of your physician might suffice.

While recovering, stay away from intense physical activities or competitive sports. This type of activity could cause pericarditis symptoms. Discuss with your physician what time you should be off.