Pericarditis overview
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Pericarditis overview On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Pericarditis is a condition in which the sac-like covering around the heart (the pericardium) becomes inflamed. Symptoms of pericarditis include chest pain which increases with deep breathing and lying flat.
Pericarditis is usually a complication of viral infections, most commonly echovirus or coxsackie virus. In addition, pericarditis can be associated with diseases such as autoimmune disorders, cancer, hypothyroidism, and kidney failure. Often the cause of pericarditis remains unknown.
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.
A careful physical examination must be performed to exclude the presence of cardiac tamponade, a dangerous complication of pericarditis. If cardiac tamponade is present, then pulsus paradoxus, hypotension, an elevated jugular venous pressure and peripheral edema may be present.
An ECG and an echocardiogram to assess for the presence of a pericardial effusion and / or cardiac tamponade are often ordered.
In cases that are thought to be due to viral pericarditis, treatment includes aspirin or a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen for inflammation of the pericardium. Corticosteroids such as prednisone and / or Colchicine may be be necessary in refractory cases. Diuretics may be prescribed to remove excess fluid in the pericardial sac.
Pericarditis is often self-limited and most people recover in 2 weeks to 3 months. However, the condition can be complicated by significant fluid buildup around the heart (cardiac tamponade) and may require urgent intervention including pericardiocentesis. If scarring of the sac around the heart (the pericardium) occurs, then this is called constrictive pericarditis which may require surgical stripping of the scar.