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Pericarditis

• Overview
• Symptoms
• Treatment
• Prevention

Treatment:

The cause of pericarditis must be identified, if possible.

In most types of pericarditis, it is necessary to treat the pain with analgesics (pain killers). The inflammation of the pericardium is treated with anti-inflammatory drugs(NSAIDS) such as aspirin and ibuprofen. Iin some cases, corticosteroids may be prescribed.

Diuretics may be used to remove excess fluid accumulated in the pericardial sac. If the buildup of pericardial fluid 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 surgically in a minor procedure.

Bacterial pericarditis must be treated with antibiotics. Fungal pericarditis is treated with antifungal agents.

If the pericarditis is chronic , recurrent, or causes constrictive pericarditis, cutting or removing part of the pericardium may be recommended.

Expectations (prognosis):

Pericarditis can range from mild cases that resolve on their own to life-threatening cases 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.

Complications:

• Arrhythmias , such as atrial fibrillation. When pericarditis accompanies myocarditis, other arrhythmias may be present, such as supraventricular tachycardia (SVT) or complete heart block.
• Cardiac tamponade
• Constrictive pericarditis, where inflammation of the pericardial sac results in fibrosis and thickening of the pericardium with adhesions (sticky scars) between the pericardium and the heart. The pericardium creates a rigid "case" around the heart, which can severely limit the ability of the heart to fill with blood. Patients with constrictive pericarditis may develop heart failure , which responds poorly to treatment. Constrictive pericarditis must be differentiated from a chronic heart condition called restrictive cardiomyopathy , which produces symptoms and signs similar to constrictive pericarditis.

Calling your health care provider:

Call your health care provider if you experience the symptoms of pericarditis. This disorder can be life-threatening if untreated.

• Review Date: 11/6/2006
• Reviewed By: Glenn Gandelman, MD, MPH, Assistant Clinical Professor of Medicine, New York Medical College, Valhalla, NY. Review provided by VeriMed Healthcare Network.

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