Understanding Pericarditis

Introduction

Pericarditis is the inflammation of the pericardium , which is a thin, sac-like membrane surrounding the heart. This condition can cause chest pain, which may feel like a sharp or stabbing sensation, and it can sometimes be mistaken for a heart attack.

Causes of Pericarditis

There are several possible causes of pericarditis, including: - Viral infections (most common, such as Coxsackievirus, Influenza) - Bacterial infections (such as tuberculosis) - Autoimmune diseases (e.g., lupus, rheumatoid arthritis) - Post-heart attack (Dressler’s syndrome) - Medical procedures (e.g., after heart surgery or catheter-based interventions) - Other conditions (kidney failure, cancer, trauma)

Symptoms of Pericarditis

• Sharp chest pain that may worsen with deep breathing or lying down
• Pain relief when sitting up and leaning forward
• Fever and chills
• Shortness of breath
• Fatigue and weakness
• Pericardial friction rub , a scratchy sound heard through a stethoscope

Diagnosis

Doctors diagnose pericarditis through: - Electrocardiogram (ECG/EKG) – Shows characteristic changes - Echocardiogram – Detects fluid around the heart (pericardial effusion) - Blood tests – To check for infection or inflammation markers - Chest X-ray, CT scan, or MRI – Helps assess pericardial thickening or fluid

Treatment

Mild cases:

• Nonsteroidal Anti-inflammatory Drugs (NSAIDs) (such as ibuprofen or aspirin)
• Colchicine – Reduces the risk of recurrence

Severe cases (complications such as tamponade):

• Corticosteroids – If NSAIDs and colchicine do not work
• Pericardiocentesis – If fluid accumulation compresses the heart
• Surgery (pericardiectomy) – In chronic or recurrent cases

Possible Complications

• Cardiac tamponade (excess fluid compressing the heart, a medical emergency)
• Constrictive pericarditis (chronic thickening and scarring of the pericardium, leading to heart dysfunction)

Recovery and Prevention

• Rest and anti-inflammatory treatment can usually lead to full recovery in a few weeks.
• Avoiding strenuous activity and following medical advice can help prevent recurrence.

When to Seek Medical Help

• Sudden, severe chest pain
• Shortness of breath
• Signs of fluid buildup around the heart (extreme fatigue, swelling in legs or abdomen)

If you experience these symptoms, seek emergency medical care as some complications of pericarditis can be life-threatening.

Source recommendations

1. American Heart Association Guidelines for 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.jacc.org/doi/10.1016/j.jacc.2019.11.021
4. https://www.sciencedirect.com/science/article/abs/pii/S1936878X24001608
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/