Pericarditis: Definition and Overview

Introduction

Pericarditis is the inflammation of the pericardium, the thin, two-layered sac surrounding the heart. This sac contains a small amount of fluid that helps reduce friction when the heart beats. Inflammation of the pericardium can lead to pain and other complications.

Causes of Pericarditis

Pericarditis can occur due to various factors, including: - Viral infections (e.g., Coxsackievirus, Epstein-Barr virus) - Bacterial infections (less common, e.g., tuberculosis) - Autoimmune diseases (e.g., lupus, rheumatoid arthritis) - Post-heart attack (Dressler’s Syndrome) - Chest trauma or surgery - Certain medications (e.g., hydralazine, procainamide)

Symptoms of Pericarditis

The most common signs include: - Sharp chest pain (often worsens when lying down and improves when sitting up) - Fever - Shortness of breath - Pericardial friction rub (a specific sound heard with a stethoscope) - Swelling in legs or abdomen (if complications like pericardial effusion occur)

Diagnosis of Pericarditis

To diagnose pericarditis, doctors use: - Electrocardiogram (ECG) to detect characteristic changes - Echocardiogram to assess pericardial fluid buildup - Blood tests to check for inflammation (CRP, ESR, troponins) - Chest X-ray or MRI to see heart structure changes

Treatment of Pericarditis

Treatment depends on the cause and severity. Common treatments include: - Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen - Colchicine to prevent recurrence - Corticosteroids (in severe or recurrent cases) - Antibiotics (if caused by a bacterial infection) - Pericardiocentesis (a procedure to remove excess fluid if necessary)

Prognosis and Prevention

Most cases of pericarditis are mild and resolve within weeks with proper treatment. However, recurrent or chronic pericarditis can occur in some individuals. Preventive measures include: - Treating underlying infections and autoimmune diseases - Avoiding unnecessary medications that can trigger pericarditis - Monitoring heart health after a heart attack or surgery

Conclusion

Pericarditis is a manageable condition with early diagnosis and proper medical care. If you experience chest pain that worsens when lying down, seek medical attention immediately.

Source recommendations

1. American Heart Association Guidelines on Pericardial Diseases

  1. https://www.ahajournals.org/doi/10.1161/circulationaha.105.561514
  2. https://www.heart.org/en/health-topics/pericarditis/what-is-pericarditis
  3. https://www.sciencedirect.com/science/article/abs/pii/S1936878X24001608
  4. https://www.jacc.org/doi/10.1016/j.jacc.2019.11.021
  5. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Pericardial-Diseases-Guidelines-on-the-Diagnosis-and-Management-of

2. European Society of Cardiology Guidelines on Pericardial Diseases

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Pericardial-Diseases-Guidelines-on-the-Diagnosis-and-Management-of
  2. https://academic.oup.com/eurheartj/article/36/42/2921/2293375
  3. https://pubmed.ncbi.nlm.nih.gov/26320112/
  4. https://www.acc.org/latest-in-cardiology/ten-points-to-remember/2015/10/30/12/01/2015-esc-guidelines-for-the-diagnosis-and-management-of-pericardial-diseases
  5. https://pubmed.ncbi.nlm.nih.gov/15120056/

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