Pericarditis (patient information): Difference between revisions

	Pericarditis
Overview
What are the symptoms?
What are the causes?
Who is at highest risk?
When to seek urgent medical care?
Diagnosis
Treatment options
Where to find medical care for Pericarditis?
What to expect (Outlook/Prognosis)?
Possible complications
Prevention
Pericarditis On the Web
Ongoing Trials at Clinical Trials.gov
Images of Pericarditis
Videos on Pericarditis
FDA on Pericarditis
CDC on Pericarditis
Pericarditis in the news
Blogs on Pericarditis
Directions to Hospitals Treating Pericarditis
Risk calculators and risk factors for Pericarditis

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Latest revision as of 15:05, 27 November 2017

For the WikiDoc page on Pericarditis, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hardik Patel, M.D.

Overview

Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.

What are the symptoms of Pericarditis?

Chest pain is almost always present, which is caused by the inflamed pericardium rubbing against the heart. The pain:

May be felt in the neck, shoulder, back, or abdomen.
Often increases with deep breathing and lying flat, and may increase with coughing and swallowing. Patients may often feel better sitting up and leaning forward.
Can be a sharp, stabbing pleuritic type pain (pleuritis).

Fever, chills, or sweating if the condition is caused by an infection.
Ankle, feet, and leg swelling (occasionally if there is a constriction of the heart filling in a condition known as constrictive pericarditis).
Anxiety
Breathing difficulty when lying down (orthopnea)
Dry cough
Fatigue

What causes Pericarditis?

The cause of pericarditis is often unknown or unproven, but is often the result of an infection such as:

Viral infections that cause a chest cold or pneumonia, such as the echovirus or coxsackie virus (which are common in children), as well as influenza
Infections with bacteria (much less common)
Some fungal infections (even more rare)

In addition, pericarditis may be seen with diseases such as:

Cancer (including leukemia)
Disorders in which the immune system attacks healthy body tissue by mistake
HIV infection and AIDS
Underactive thyroid gland
Kidney failure
Rheumatic fever
Tuberculosis (TB)

Other causes include:

Heart attack
Heart surgery or trauma to the chest, esophagus, or heart
Certain medications, such as procainamide, hydralazine, phenytoin, isoniazid, and some drugs used to treat cancer or suppress the immune system
Swelling or inflammation of the heart muscle
Radiation therapy to the chest

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 signs of a build up of fluids within the pericardium, which is referred to as a cardiac tamponade. A cardiac tamponade is a condition in which the heart cannot expand to accept blood.

Diagnosis

When listening to the heart with a stethoscope, the health care provider can hear a sound called a pericardial rub. The heart sounds may be muffled or distant. There may be other signs of fluid in the pericardium (pericardial effusion).

If the disorder is severe, there may be:

Crackles in the lungs
Decreased breath sounds
Other signs of fluid in the space around the lungs (pleural effusion)

The following imaging tests may be done to check the heart and the layer of tissue that surrounds it (pericardium):

To look for heart muscle damage, the health care provider may order a troponin I test. Other laboratory tests may include:

Treatment options

The cause of pericarditis must be identified, if possible.

High doses of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are often given. These medicines will decrease your pain and reduce the swelling or inflammation in the sac around your heart.

A medicine called colchicine may be added, especially if pericarditis does not go away after 1 to 2 weeks or it comes back weeks or months later.

If the cause of pericarditis is an infection:

Antibiotics will be used for bacterial infections
Antifungal medications will be used for fungal pericarditis

Other medications that may be used are:

Corticosteroids such as prednisone (in some patients)
"Water pills" (diuretics) to remove excess fluid

If the buildup of fluid makes the heart function poorly, treatment may include:

Draining the fluid from the sac. This procedure, called pericardiocentesis, may be done using an echocardiography-guided needle.
Cutting a small hole (window) in the pericardium (subxiphoid pericardiotomy) to allow the infected fluid to drain into the abdominal cavity.

If the pericarditis is chronic, recurrent, or causes scarring or tightening of the tissue around the heart, cutting or removing part of the pericardium may be needed. This surgery is called a 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 fluid buildup around the heart and poor heart function.

The outcome is good if the disorder is treated right away. Most people recover in 2 weeks to 3 months. However, pericarditis may come back. This is called recurrent, or chronic if symptoms or episodes continue.

Scarring and thickening of the sac-like covering of the heart muscle may occur in severe cases. This is called constrictive pericarditis, and it can cause long-term problems similar to those of heart failure.

Possible complications

Pericardial effusion or accumulation of fluid around the heart.
Cardiac tamponade or compression on the heart by the fluid that prevents the heart from filling normally.
Constrictive pericarditis which is scarring of the sac around the heart that prevents the heart from filling normally.

Prevention

Many cases are not preventable.

Videos

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000182.htm Template:WH Template:WS

@@ Line 1: / Line 1: @@
-{{Pericarditis}}
+__NOTOC__
+{{Pericarditis (patient information)}}
-'''For the WikiDoc page for this topic, click [[Pericarditis|here]]'''
+'''For the WikiDoc page on Pericarditis, click [[Pericarditis|here]]'''
-'''Editors-in-Chief:''' C. Michael Gibson, M.S., M.D.; Prashant Sharma
+{{CMG}}; {{AE}} {{HP}}
-==What is Diseases of the pericardium?==
+==Overview==
 [[Pericarditis]] is a condition in which the sac-like covering around the heart ([[pericardium]]) becomes inflamed.
-==What are the symptoms of Diseases of the pericardium?==
+==What are the symptoms of Pericarditis?==
-*Chest pain, caused by the inflamed pericardium rubbing against the heart.
+*[[Chest pain]] is almost always present, which is caused by the inflamed [[pericardium]] rubbing against the [[heart]]. The pain:
-May radiate to the neck, shoulder, back, or abdomen.
+:*May be felt in the neck, shoulder, back, or abdomen.
-Often increases with deep breathing and lying flat, and may increase with coughing and swallowing.
+:*Often increases with deep breathing and lying flat, and may increase with [[coughing]] and [[swallowing]]. Patients may often feel better sitting up and leaning forward.
-[[Pleuritis]] type: a sharp, stabbing pain.
+:*Can be a sharp, stabbing [[pleuritic]] type pain ([[pleuritis]]).
-Usually relieved by sitting up and leaning forward.
+*[[Fever]], chills, or sweating if the condition is caused by an infection.
-*Fever
+*Ankle, feet, and [[leg swelling]] (occasionally if there is a constriction of the heart filling in a condition known as [[constrictive pericarditis]]).
-*Ankle, feet, and leg swelling (occasionally).
+*[[Anxiety]]
-*Anxiety
+*[[Breathing difficulty]] when lying down ([[orthopnea]])
-*Breathing difficulty when lying down.
+*Dry [[cough]]
-*Dry cough
+*[[Fatigue]]
-*Fatigue
-*Need to bend over or hold the chest while breathing.
-==What causes Diseases of the pericardium?==
+==What causes Pericarditis?==
-Pericarditis is usually a complication of viral infections, most commonly [[echovirus]] or [[coxsackie virus]]. Less frequently, it is caused by [[influenza]] or [[HIV infection]].
+The cause of pericarditis is often unknown or unproven, but is often the result of an [[infection]] such as:
+*[[Viral infection]]s that cause a chest cold or [[pneumonia]], such as the [[echovirus]] or [[coxsackie virus]] (which are common in children), as well as [[influenza]]
+*Infections with [[bacteria]] (much less common)
+*Some [[fungal infection]]s (even more rare)
-Infections with bacteria can lead to bacterial pericarditis (also called purulent(pus) pericarditis). Some fungal infections can also produce pericarditis.
+In addition, pericarditis may be seen with diseases such as:
+*[[Cancer]] (including [[leukemia]])
+*Disorders in which the [[immune system]] attacks healthy body tissue by mistake
+*[[HIV]] infection and [[AIDS]]
+*Underactive [[thyroid gland]]
+*[[Kidney failure]]
+*[[Rheumatic fever]]
+*[[Tuberculosis]] (TB)
+Other causes include:
+*[[Heart attack]]
+*[[Heart surgery]] or trauma to the chest, [[esophagus]], or [[heart]]
+*Certain medications, such as [[procainamide]], [[hydralazine]], [[phenytoin]], [[isoniazid]], and some drugs used to treat cancer or suppress the [[immune system]]
+*[[Swelling]] or [[inflammation]] of the heart muscle
+*[[Radiation]] therapy to the chest
+==Who is at highest risk?==
+Pericarditis most often affects men aged 20 - 50. It usually follows [[respiratory infection]]s.
-In addition, pericarditis can be associated with diseases such as:
+==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 signs of a build up of fluids within the [[pericardium]], which is referred to as a [[cardiac tamponade]]. A cardiac tamponade is a condition in which the heart cannot expand to accept blood.
-*[[Autoimmune disorders]]
+==Diagnosis==
-*[[Cancer]] (including leukemia)
+When listening to the [[heart]] with a stethoscope, the health care provider can hear a sound called a [[pericardial rub]]. The heart sounds may be muffled or distant. There may be other signs of fluid in the [[pericardium]] ([[pericardial effusion]]).
-*[[HIV infection]] and [[AIDS]]
-*[[Hypothyroidism]]
-*[[Kidney failure]]
-*[[Rheumatic fever]]
-*[[Tuberculosis]]
-Other causes include:
-Heart attack (see [[post-MI pericarditis]])
+If the disorder is severe, there may be:
-Injury (including surgery) or trauma to the chest, esophagus(food pipe), or heart
+*Crackles in the [[lung]]s
-Medications that suppress the immune system
+*Decreased breath sounds
-[[Myocarditis]]
+*Other signs of fluid in the space around the lungs ([[pleural effusion]])
-Radiation therapy to the chest
-Often the cause of [[pericarditis]] remains unknown. In this case, the condition is called idiopathic(unknown cause) pericarditis.
-Pericarditis most often affects men aged 20 - 50. It usually follows respiratory infections. In children, it is most commonly caused by [[adenovirus]] or [[coxsackie virus]].
+The following imaging tests may be done to check the heart and the layer of tissue that surrounds it ([[pericardium]]):
+*Chest [[MRI]] scan
+*[[Chest x-ray]]
+*[[Echocardiogram]]
+*[[Electrocardiogram]]
+*[[Heart MRI]] or heart [[CT]] scan
+*[[Radionuclide]] scanning
-==When to seek urgent medical care==
+To look for heart muscle damage, the health care provider may order a [[troponin I]] test. Other laboratory tests may include:
-[[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 maybe ominous signs and may indicate build up of fluids within the [[pericardium]], called [[cardiac tamponade]].
+*[[Antinuclear antibody]] (ANA)
+*[[Blood culture]]
+*[[CBC]]
+*[[C-reactive protein]]
+*Erythrocyte sedimentation rate ([[ESR]])
+*[[HIV]] test
+*[[Rheumatoid factor]]
+*[[Tuberculin skin test]]
 ==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.
-*[[Chest MRI scan]]
-*Chest x-ray
+High doses of nonsteroidal anti-inflammatory drugs ([[NSAID]]s) such as [[ibuprofen]] are often given. These medicines will decrease your pain and reduce the swelling or inflammation in the sac around your heart.
-*ECG
-*[[Echocardiogram]]
-*Heart MRI or [[heart CT scan]]
-*[[Radionuclide scanning]]
-Medications include:
+A medicine called [[colchicine]] may be added, especially if pericarditis does not go away after 1 to 2 weeks or it comes back weeks or months later.
-*[[Analgesics]] for pain
+If the cause of pericarditis is an [[infection]]:
-*Antibiotics for [[bacterial pericarditis]]
+*[[Antibiotic]]s will be used for [[bacterial infection]]s
-*[[Antifungal medications]] for [[fungal pericarditis]]
+*[[Antifungal]] medications will be used 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 is 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.
+Other medications that may be used are:
+*[[Corticosteroid]]s such as [[prednisone]] (in some patients)
+*"Water pills" ([[diuretic]]s) to remove excess fluid
-==Where to find medical care for Diseases of the pericardium==
+If the buildup of fluid makes the heart function poorly, treatment may include:
-[http://maps.google.com/maps?f=q&amp;hl=en&amp;geocode=&amp;q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|Diseases of the pericardium}}}}&amp;sll=37.0625,-95.677068&amp;sspn=65.008093,112.148438&amp;ie=UTF8&amp;ll=37.0625,-95.677068&amp;spn=91.690419,149.414063&amp;z=2&amp;source=embed    Directions to Hospitals Treating Diseases of the pericardium]
+*Draining the fluid from the sac. This procedure, called [[pericardiocentesis]], may be done using an echocardiography-guided needle.
+*Cutting a small hole (window) in the pericardium (subxiphoid pericardiotomy) to allow the infected fluid to drain into the abdominal cavity.
-==What to expect (Outlook/Prognosis)==
+If the pericarditis is [[chronic]], recurrent, or causes scarring or tightening of the tissue around the heart, cutting or removing part of the pericardium may be needed. This surgery is called a [[pericardiectomy]].
-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.
+==Where to find medical care for Pericarditis?==
+[http://maps.google.com/maps?q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|map+top+hospital+Pericarditis}}}}&oe=utf-8&rls=org.mozilla:en-US:official&client=firefox-a&um=1&ie=UTF-8&sa=N&hl=en&tab=wl 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 fluid buildup around the [[heart]] and poor heart function.
+The outcome is good if the disorder is treated right away. Most people recover in 2 weeks to 3 months. However, pericarditis may come back. This is called recurrent, or chronic if symptoms or episodes continue.
+Scarring and thickening of the sac-like covering of the heart muscle may occur in severe cases. This is called [[constrictive pericarditis]], and it can cause long-term problems similar to those of [[heart failure]].
 ==Possible complications==
-*Arrhythmias
+*[[Pericardial effusion]] or accumulation of fluid around the heart.
-*Cardiac tamponade
+*[[Cardiac tamponade]] or compression on the heart by the fluid that prevents the heart from filling normally.
-*Constrictive pericarditis, which may develop into heart failure.
+*[[Constrictive pericarditis]] which is scarring of the sac around the heart that prevents the heart from filling normally.
+==Prevention==
+Many cases are not preventable.
+==Videos==
+{{#ev:youtube|lJ6KzpnjbRg}}
 ==Sources==
 http://www.nlm.nih.gov/medlineplus/ency/article/000182.htm
-{{SIB}}
 {{WH}}
 {{WS}}
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+[[Category:Patient information]]
+[[Category:Up-To-Date cardiology]]
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