Pericarditis

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What is Pericarditis?

Pericarditis is inflammation of the pericardial sac, which is the fibroelastic sac that surrounds the heart.

What Are The Causes of Pericarditis?

Most cases of pericarditis are idiopathic, meaning that they have no identifiable cause. It is likely that they are due to a viral infection that leads to inflammation. Other causes include heart attack, malignancy, tuberculosis, and autoimmune-related conditions.

What Are The Signs And Symptoms of Pericarditis?

Pericarditis can present with nonspecific signs and symptoms. Most commonly, it includes pleuritic chest pain, or chest pain that is worse with deep inhalation. There can also be a pericardial friction rub on physical exam and changes in the electrocardiogram.

What Are The Risk Factors of Pericarditis?

Risk factors for pericarditis include past heart attacks, autoimmune diseases, trauma, certain bacterial, viral, or fungal infections, and kidney failure.

How is Pericarditis Diagnosed?

Your physician may order blood work to check inflammatory markers in the blood as well as biomarkers of myocardial injury. Acute pericarditis is diagnosed when a patient has at least two of the following criteria:

  • Sharp chest pain that is worse with deep inhalation, improved by sitting up and leaning forward
  • Pericardial friction rub on auscultation.
  • Changes on the ECG, typically widespread ST-segment elevation
  • New or worsening pericardial effusion

What Are Possible Treatments For Pericarditis?

Treatments typically aim to treat a viral infection with nonsteroidal anti-inflammatory drugs and colchicine. The goals of therapy are pain relief, reduction of inflammation, and prevention of recurrence. Most patients are treated in the outpatient setting, and are instructed to restrict strenuous activity until symptoms have resolved. High risk patients (those with fever, cardiac tamponade, large pericardial effusion, immunosuppression, acute trauma) are admitted to the hospital to initiate appropriate treatment. Caution should be taken in those with bleeding risk due to administration of NSAIDs.

Are There Preventative Steps or Measures To Avoid Pericarditis?

Acute pericarditis cannot be prevented. If you have already been diagnosed with pericarditis, it is important to be treated properly and complete your treatment plan.

What Are The Risks If Pericarditis Is Left Untreated?

Untreated pericarditis can lead to constrictive pericarditis, where the pericardium becomes thickened and scarred. When this occurs, the heart is unable to pump as effectively as it should. Cardiac tamponade is also a potential complication of untreated pericarditis. This occurs when there is fluid in the pericardial sac that puts pressure on the heart, causing a decrease in the amount of blood that the heart can pump.

Can Covid Cause Pericarditis?

As discussed earlier, the most common etiology of pericarditis are viral infections. COVID-19 is a viral infection, so pericarditis can occur.

Are There Other Related Conditions To Pericarditis?

Untreated pericarditis can lead to constrictive pericarditis, where the pericardium becomes thickened and scarred. When this occurs, the heart is unable to pump as effectively as it should. Cardiac tamponade is also a potential complication of untreated pericarditis. This occurs when there is fluid in the pericardial sac that puts pressure on the heart, causing a decrease in the amount of blood that the heart can pump.

Key Takeaways About Pericarditis

Pericarditis is inflammation of the pericardial sac, which is the fibroelastic sac that surrounds the heart. Most cases of pericarditis are likely due to a viral infection that leads to inflammation. It commonly presents with pleuritic chest pain, or chest pain that is worse with deep inhalation. The pain is improved with leaning forward. Treatments typically aim to treat a viral infection with nonsteroidal anti-inflammatory drugs and colchicine. If diagnosed, it is important to be treated properly and complete your treatment plan.

Meet Manhattan Cardiology

Robert Segal, MD, FACC, RPVI is the founder of Manhattan Cardiology. Dr. Segal is a Board Certified Cardiologist and a Fellow of the American College of Cardiology (FACC). Learn More »

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