Pericarditis
Pericarditis Overview
Pericarditis describes the condition in which the pericardium, the thin membrane surrounding the heart, becomes inflamed and irritated. Sharp chest pains associated with pericarditis occur when the two layers of the pericardium rub against each other. Acute pericarditis usually lasts only a few weeks, while chronic pericarditis persists for months and develops gradually.
Pericarditis is usually a complication of viral infections, most commonly echovirus or coxsackie virus. Sometimes, the disorder may develop after a heart attack, secondary to the irritation of the heart muscle underlying the pericardium. In rare cases, it is associated with influenza or HIV infections. Often, the cause of the condition is unknown.
In more severe forms of pericarditis, the inflamed layers of the pericardium might stiffen and develop scar tissue (constrictive pericarditis).
If the tissue becomes thickened and sticks together, limiting the heart’s normal filling, symptoms may resemble heart failure. Alternatively, fluid may fill the space between the layers of the pericardium, causing a pericardial effusion. If the build-up is rapid, it can further lead to cardiac tamponade, a potentially life-threatening condition that impairs heart functions and requires emergency drainage.
Symptoms
With acute pericarditis, the most common symptom is sharp, stabbing pain behind the breastbone or in the left side of your chest. Sometimes, the pain can be dull and achy with varying intensity. The pain may also travel into your left shoulder and across your neck, intensifying when you lie down or inhale deeply. It eases when you sit up or lean forward.
Chronic pericarditis, however, is less intense and often painless and is associated with excess fluid developing around the heart (pericardial effusion). The most common symptom of chronic pericarditis is shortness of breath. Other symptoms of both forms of this disorder are similar to those related to other heart-related conditions. These include:
- Shortness of breath even with limited activity
- Swelling of the feet, ankles, hands or abdomen
- Rapid or irregular heartbeat or pulse
- Dizziness or fainting
- Anxiety or fatigue
- Fever
Risk Factors
Pericarditis most often affects men aged 20 to 50 and usually follows respiratory infections. In children, it is most often caused by adenovirus or coxsackie virus.
Pericarditis Prevention
Most initial cases of acute pericarditis cannot be prevented. Medication can help reduce the likelihood of acute pericarditis from reoccurring or evolving into chronic pericarditis.
Reduce Your Risk of Pericarditis
You can lower your chances of recurring forms of pericarditis by getting prompt treatment, and adhering to the plan you and your Wellstar physician agree to.
Tests and Screenings
In diagnosing for pericarditis, your Wellstar physician will take a careful medical history and perform a physical examination. With a stethoscope, your physician can listen for a muffled and distant sound in your heart called a pericardial rub as well as other signs.
Based on the exam, your physician might order some of these tests:
- Chest X-ray to evaluate for radiographic signs of an enlarged heart.
- Electrocardiogram (ECG) to record the electrical activity of your heart and to evaluate for an arrhythmia or a prior heart attack.
- Echocardiogram, an ultrasound test, designed to show the pumping performance of your heart.
- Cardiac Stress Tests which measure your heart’s performance during exertion.
- Coronary Catheterization or angiogram in which a thin, flexible tube (catheter) is inserted into your groin or arm and guided through the aorta into your heart. Dye is injected through the tube to evaluate the arteries that deliver blood and oxygen to the heart.
- Cardiac Computerized Tomography (CT) Scan or Magnetic Resonance Imaging (MRI), which can provide a three-dimensional image of your heart.
- Blood tests to check your kidney, thyroid or liver functions and to ensure there has not been a heart attack.
Pericarditis Diagnosis
If screening tests or check-ups reveal abnormal results, your Wellstar physician may perform further evaluations regarding pericarditis. Nevertheless, the majority of cases are diagnosed by history and physical examination.
Procedures
- Physical Examination
- Chest X-rays
- Electrocardiogram (ECG)
- Echocardiogram
- Cardiac Stress Tests
- Cardiac Computerized Tomography (CT) Scan or Magnetic Resonance Imaging (MRI)
- Coronary Catheterization or angiogram
- Blood tests
Pericarditis Treatment
Treatment of pericarditis depends on the cause as well as the severity of the condition. In mild cases of pericarditis, patients may get better on their own without treatment. In others cases, medications and bed rest may be required. In some instances, medical procedures or surgery become necessary.
Medications
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Medical Procedures and Surgery
In some cases, your Wellstar physician may recommend more invasive treatments, particularly in instances of cardiac tamponade, a dangerous form of pericarditis associated with rapid fluid build-up, or in recurrent pericarditis. Such procedures include:
- Pericardiocentesis, in which your Wellstar cardiologist uses a sterile needle or small tube (catheter) to remove and drain the excess fluid from the pericardial cavity.
- Pericardiectomy, a surgical procedure to remove those portions of the pericardium that has become rigid and is compromising the performance of your heart.
Ongoing Care for Pericarditis
Wellstar’s world-class, community-based physicians utilize state-of-the-art medical centers and hospitals with the latest technologies and medical resources.
Other clinicians are dedicated to:
- Helping you create and maintain healthy lifestyles
- Offering advice to prevent illness and injuries
- Providing early and appropriate care of acute illness to prevent its progression
Heart Care at Wellstar
Wellstar provides top-flight Cardiac Care throughout its physicians’ offices, urgent care centers and emergency rooms. Emergency departments at Wellstar Cobb, Wellstar Douglas, and Wellstar Kennestone hospitals provide comprehensive cardiac services. Wellstar Cobb and Wellstar Kennestone hospital’s cardiac diagnostic and treatment services provide the next level of defense against heart disease. The technologically advanced Cardiac Center at Wellstar Kennestone Hospital and partnership with Emory Healthcare for adult open-heart surgery raises the bar on world-class cardiac care. Wellstar’s Cardiac Rehabilitation Services’ medically supervised programs focus on helping heart disease patients maintain a healthier heart through education and support groups.
Ongoing Care at Home
Proper care and treatment of pericarditis can often improve symptoms and help you live longer. You and your Wellstar physician can work together to make your life more comfortable, so pay close attention to your body and your post-treatment regiment and keep your doctor updated.
As part of your post-treatment care and in addition to maintaining a healthy diet and exercise, you should:
- Seek prompt medical attention when symptoms increase in severity.
- Keep track of all medications you take. Keep track of your weight and blood pressure.
- Write down your questions, and never be afraid to ask your Wellstar physicians for clarification regarding your condition or your treatment.