Pericarditis is inflammation of the pericardial sac, which is the fibroelastic sac that surrounds the heart.
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.
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.
Risk factors for pericarditis include past heart attacks, autoimmune diseases, trauma, certain bacterial, viral, or fungal infections, and kidney failure.
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:
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.
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.
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.
As discussed earlier, the most common etiology of pericarditis are viral infections. COVID-19 is a viral infection, so pericarditis can occur.
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.
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.