Pericarditis (patient information): Difference between revisions
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*[[Chest pain]], which is caused by the inflamed pericardium rubbing against the heart. The pain may radiate to the neck, shoulder, back, or abdomen. The pain often increases with deep breathing and lying flat, and may increase with coughing and swallowing. Patient's may often feel better sitting up and leaning forward. There may be a [[pleuritic]] type pain ([[Pleuritis]]) which is a sharp, stabbing pain. In addition, the following symptoms may be observed: | *[[Chest pain]], which is caused by the inflamed pericardium rubbing against the heart. The pain may radiate to the neck, shoulder, back, or abdomen. The pain often increases with deep breathing and lying flat, and may increase with coughing and swallowing. Patient's may often feel better sitting up and leaning forward. There may be a [[pleuritic]] type pain ([[Pleuritis]]) which is a sharp, stabbing pain. In addition, the following symptoms may be observed: | ||
*[[Fever]] | *[[Fever]] | ||
*Ankle, feet, and [[leg swelling]] (occasionally if there is a constriction of the heart filling). | *Ankle, feet, and [[leg swelling]] (occasionally if there is a constriction of the heart filling ( a condition known as [[constrictive pericarditis]]). | ||
*[[Anxiety]] | *[[Anxiety]] | ||
*[[Orthopnea]] or breathing difficulty when lying down. | *[[Orthopnea]] or breathing difficulty when lying down. | ||
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==What causes Pericarditis?== | ==What causes Pericarditis?== | ||
Pericarditis is usually a complication of viral infections, most commonly [[echovirus]] or [[coxsackie virus]]. | Pericarditis is usually a complication of viral infections, most commonly [[echovirus]] or [[coxsackie virus]]. In children, it is most commonly caused by [[adenovirus]] or [[coxsackie virus]]. Often the cause of [[pericarditis]] remains unknown. In this case, the condition is called idiopathic(unknown cause) pericarditis. | ||
In addition, pericarditis can be associated with diseases such as: | In addition, pericarditis can be associated with diseases such as: | ||
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*[[Autoimmune disorders]] | *[[Autoimmune disorders]] | ||
*[[Cancer]] (including leukemia) | *[[Cancer]] (including leukemia) | ||
*Heart attack (see [[Dressleer's syndrome|post-MI pericarditis]]) | |||
*[[HIV infection]] and [[AIDS]] | *[[HIV infection]] and [[AIDS]] | ||
*[[Hypothyroidism]] | *[[Hypothyroidism]] | ||
*Infections with bacteria can lead to bacterial pericarditis (also called purulent(pus) pericarditis). Some fungal infections can also produce pericarditis. | |||
*[[Kidney failure]] | *[[Kidney failure]] | ||
*Medications | |||
*[[Myocarditis]] a condition in which the heart is inflamed | |||
*[[radiation therapy]] | |||
*[[Rheumatic fever]] | *[[Rheumatic fever]] | ||
*Trauma (including surgery) or trauma to the chest, esophagus(food pipe), or heart | |||
*[[Tuberculosis]] | *[[Tuberculosis]] | ||
Pericarditis most often affects men aged 20 - 50. It usually follows respiratory infections | ==Who is at highest risk?== | ||
Pericarditis most often affects men aged 20 - 50. It usually follows respiratory infections. | |||
==When to seek urgent medical care== | ==When to seek urgent medical care== | ||
[[Pericarditis]] can be potentially life threatening and one should seek medical care when suffering from symptoms of [[pericarditis]]. Severe chest pain, fainting, palpitations and high grade fever | [[Pericarditis]] can be potentially life threatening and one should seek medical care when suffering from symptoms of [[pericarditis]]. Severe [[chest pain]], [[fainting]], [[palpitations]] and high grade [[fever]] may be ominous signs and may indicate build up of fluids within the [[pericardium]], a condition called [[cardiac tamponade]] where the heart cannot expand to accept blood. | ||
==Treatment options== | ==Treatment options== | ||
The cause of [[pericarditis]] must be identified, if possible, for this the physician may decide to do the following: | The cause of [[pericarditis]] must be identified, if possible, for this the physician may decide to do the following: | ||
*[[Chest MRI scan]] | *[[Chest MRI scan]] | ||
*Chest x-ray | *[[Chest x-ray]] | ||
*ECG | *[[ECG]] | ||
*[[Echocardiogram]] | *[[Echocardiogram]] | ||
*Heart MRI or [[heart CT scan]] | *Heart [[MRI]] or [[heart CT scan]] | ||
*[[Radionuclide scanning]] | *[[Radionuclide scanning]] | ||
Medications include: | Medications to treat pericarditis may include: | ||
*[[Analgesics]] for pain | *[[Analgesics]] for pain | ||
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*[[Antifungal medications]] for [[fungal pericarditis]] | *[[Antifungal medications]] for [[fungal pericarditis]] | ||
*[[Aspirin]] or a [[nonsteroidal anti-inflammatory drug (NSAID)]] such as [[ibuprofen]] for inflammation of the [[pericardium]] | *[[Aspirin]] or a [[nonsteroidal anti-inflammatory drug (NSAID)]] such as [[ibuprofen]] for inflammation of the [[pericardium]] | ||
*[[ | *[[Corticosteroids]] such as [[prednisone]] | ||
*[[Colchicine]] | *[[Colchicine]] | ||
*[[Diuretics]] to remove excess fluid in the [[pericardial sac]] | *[[Diuretics]] to remove excess fluid in the [[pericardial sac]] | ||
If the buildup of fluid in the [[pericardium]] makes the heart function poorly or produces [[cardiac tamponade]], it | If the buildup of fluid in the [[pericardium]] makes the heart function poorly or produces [[cardiac tamponade]], it may be necessary to drain the fluid from the sac. This procedure, called [[pericardiocentesis]], may be done using an [[echocardiography-guided needle]] or minor surgery. | ||
If the [[pericarditis]] is chronic, recurrent, or causes [[constrictive pericarditis]], cutting or removing part of the [[pericardium]] may be recommended. | If the [[pericarditis]] is chronic, recurrent, or causes [[constrictive pericarditis]], cutting or removing part of the [[pericardium]] may be recommended as part of a procedure called [[pericardiectomy]]. | ||
==Where to find medical care for Pericarditis== | ==Where to find medical care for Pericarditis== | ||
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==Possible complications== | ==Possible complications== | ||
*[[Pericardial effusion]] or accumulation of fluid around the heart | *[[Pericardial effusion]] or accumulation of fluid around the heart. | ||
*[[Cardiac tamponade]] or compression of fluid on the heart that prevents the heart from filling normally | *[[Cardiac tamponade]] or compression of fluid on the heart that prevents the heart from filling normally. | ||
*[[Constrictive pericarditis]] which is scarring of the sack around the heart that prevents the heart from filling normally | *[[Constrictive pericarditis]] which is scarring of the sack around the heart that prevents the heart from filling normally. | ||
==Sources== | ==Sources== | ||
Revision as of 14:10, 16 July 2011
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Pericarditis (patient information) On the Web |
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Risk calculators and risk factors for Pericarditis (patient information) |
For the WikiDoc page for this topic, click here
Editors-in-Chief: C. Michael Gibson, M.S., M.D.; Prashant Sharma
What is pericarditis?
Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.
What are the symptoms of pericarditis?
- Chest pain, which is caused by the inflamed pericardium rubbing against the heart. The pain may radiate to the neck, shoulder, back, or abdomen. The pain often increases with deep breathing and lying flat, and may increase with coughing and swallowing. Patient's may often feel better sitting up and leaning forward. There may be a pleuritic type pain (Pleuritis) which is a sharp, stabbing pain. In addition, the following symptoms may be observed:
- Fever
- Ankle, feet, and leg swelling (occasionally if there is a constriction of the heart filling ( a condition known as constrictive pericarditis).
- Anxiety
- Orthopnea or breathing difficulty when lying down.
- Dry cough
- Fatigue
What causes Pericarditis?
Pericarditis is usually a complication of viral infections, most commonly echovirus or coxsackie virus. In children, it is most commonly caused by adenovirus or coxsackie virus. Often the cause of pericarditis remains unknown. In this case, the condition is called idiopathic(unknown cause) pericarditis.
In addition, pericarditis can be associated with diseases such as:
- Autoimmune disorders
- Cancer (including leukemia)
- Heart attack (see post-MI pericarditis)
- HIV infection and AIDS
- Hypothyroidism
- Infections with bacteria can lead to bacterial pericarditis (also called purulent(pus) pericarditis). Some fungal infections can also produce pericarditis.
- Kidney failure
- Medications
- Myocarditis a condition in which the heart is inflamed
- radiation therapy
- Rheumatic fever
- Trauma (including surgery) or trauma to the chest, esophagus(food pipe), or heart
- Tuberculosis
Who is at highest risk?
Pericarditis most often affects men aged 20 - 50. It usually follows respiratory infections.
When to seek urgent medical care
Pericarditis can be potentially life threatening and one should seek medical care when suffering from symptoms of pericarditis. Severe chest pain, fainting, palpitations and high grade fever may be ominous signs and may indicate build up of fluids within the pericardium, a condition called cardiac tamponade where the heart cannot expand to accept blood.
Treatment options
The cause of pericarditis must be identified, if possible, for this the physician may decide to do the following:
Medications to treat pericarditis may include:
- Analgesics for pain
- Antibiotics for bacterial pericarditis
- Antifungal medications for fungal pericarditis
- Aspirin or a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen for inflammation of the pericardium
- Corticosteroids such as prednisone
- Colchicine
- Diuretics to remove excess fluid in the pericardial sac
If the buildup of fluid in the pericardium makes the heart function poorly or produces cardiac tamponade, it may be necessary to drain the fluid from the sac. This procedure, called pericardiocentesis, may be done using an echocardiography-guided needle or minor surgery.
If the pericarditis is chronic, recurrent, or causes constrictive pericarditis, cutting or removing part of the pericardium may be recommended as part of a procedure called pericardiectomy.
Where to find medical care for Pericarditis
Directions to Hospitals Treating Pericarditis
What to expect (Outlook/Prognosis)
Pericarditis can range from mild cases that get better on their own to life-threatening cases. The condition can be complicated by significant fluid buildup around the heart and poor heart function.
The outcome is good if the disorder is treated promptly. Most people recover in 2 weeks to 3 months. However, pericarditis may come back.
Possible complications
- Pericardial effusion or accumulation of fluid around the heart.
- Cardiac tamponade or compression of fluid on the heart that prevents the heart from filling normally.
- Constrictive pericarditis which is scarring of the sack around the heart that prevents the heart from filling normally.