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Pericarditis (more information)

Overview

Pericardial disease or pericardits is inflammation of any layers of the pericardium. The pericardium is a thin fibrous membrane sac that surrounds the heart and consists of:

• Inner layer (visceral pericardium) that envelopes the entire heart.
• Outer layer (parietal pericardium) comprising the outer fibrous sac.
• Middle fluid layer to prevent friction between the parietal pericardim and visceral pericardium.

Risk factors

The risk factors and/or causes for pericarditis are:

• High cholesterol
• High blood pressure
• Male sex
• Race
• Obesity
• Infections
• Heart surgery
• Heart attack
• Trauma
• Tumors
• Cancer
• Radiation
• Autoimmune diseases (such as rheumatoid arthritis, lupus, or scleroderma)

For some people, no cause can be found.

Pericarditis can be acute (occurring suddenly) or chronic (occur over time).

Prevention and Planning Ahead

To prevent pericarditis control as many risk factors as possible. See your doctor immediately if you experience any pericarditis or constructive pericardits symptoms.

Warning Signs and Symptoms

If you have pericardits you may experience:

• Chest pain. This pain is different from angina (pain caused by coronary artery disease). It may be sharp and located in the center of the chest. The pain may radiate to the neck and occasionally, to the arms and back. The pain worsens when you lie down, cough, or swallow. The pain is relieved by sitting forward.
• Low-grade fever.
• Increased heart rate.

Diagnosis

Your doctor can diagnose pericarditis by asking about your symptoms, examining EKG results, and performing a physical exam. The tests used to diagnose pericarditis are used to diagnose constrictive pericarditis. Other diagnostic tests used for constricutve pericarditis:

• Echocardiogram
• Cardiac catheterization
• MRI
• CT scan

Complications

One complication of pericarditis is constructive pericarditis. In constructive pericarditis, the layers of the pericardium may become stiff and stick together. This prevents the heart muscle form expanding during filling and impacts the function of the heart. The symptoms of constructive pericarditis are the same as pericarditis with the addition of:

• Shortness of breath.
• Fatigue (feeling over-tired).
• Heart failure symptoms (swelling of legs and feet, un-explained weight gain).
• Atrial fibrillation

Intervention/Treatment

Treatment for pericarditis is based on the cause and may include:

• Non-steroidal anti-inflammatory agents (NSAIDs) to decrease the pain and inflammation.
• Steroids, used occasionally for severe attacks.
• Antibiotics, if the pericarditis is due to infection.

Constructive pericarditis may be treated by:

• Analgesics and anti-inflammatory agents to treat pain or inflammation.
• Diuretics to treat heart failure symptoms.
• Antiarrhythmics to treat any heart arrhythmias, such as Atrial fibrillation
• Pericardiectomy (the surgical removal of the stiff pericardium from the heart).

Alternative Medicine

The following site may be useful as you search for alternative solutions to pericardial disease:

• Holistic Heart Health www.holistichearthealth.com/

Frequently Asked Questions

Q: How can I tell if my chest pain is caused by pericarditis?

A: Chest pain caused by pericaditis worsens when you lie down, cough, or swallow. The pain may be accompanied by a rapid heart rate and low-grade fever. These same symptoms may also signal the presence of gall bladder disease, a pulmonary embolus (clot in the lungs' blood vessels), or pneumonia. Your best bet is to call your doctor for prompt evaluation or go to the hospital emergency room for immediate care and testing.

Q: If I have sharp chest pain that shoots or radiates to my arms, back, jaw, or neck, does that mean I am having a heart attack?

A: That type of pain may be associated with pericarditis, angina (a lack of blood flow to the heart), or a heart attack (myocardial infarction). Let a doctor make the call!

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