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Pericarditis: Treatment, symptoms, advice and help

About pericarditis

Pericarditis is termed as inflammation of the pericardium, which is a sac surrounding the heart. Pericarditis may have a sudden onset or may be present for a longer duration. Sudden onset of pericarditis is called ‘acute pericarditis’, which is the commonest presentation.

Pericarditis: Incidence, age and sex

Pericarditis is a rarely occurring disease. It usually affects men aged 20 to 50 years, but may also arise in children following certain viral infections.

Signs and symptoms of pericarditis: Diagnosis

The signs and symptoms of pericarditis usually vary. However, the most common symptom is sharp chest pain on the left side of chest which becomes worst on deep breathing or lying down. Pain is accompanied by low-grade temperature, muscle pain, and cough. Patient may also feel tired and weak. Typically, symptoms develop in one to three weeks starting with temperature, chest discomfort, cough, shortness of breath, and general malaise.

It is advisable to get oneself examined by a physician if individuals experience such symptoms. Investigations including radiological examination of the chest like a chest x-ray, and echocardiography, may help in establishing the diagnosis.

Causes and prevention of pericarditis

There can be many reasons for causation of acute pericarditis and pericardial effusion, including viruses, bacteria, fungi, cancer, trauma to the heart (such as chest injury), drug reactions, and radiation exposure. In many cases, however, the actual cause is not known. Constrictive pericarditis usually results from repeated (chronic) pericarditis.

Other causes of pericarditis may be non-infectious, and include underlying heart muscle injury, cancer, rheumatoid arthritis, medications like minoxidil and penicillin, lupus erythematosus, and kidney failure. Even young, otherwise healthy individuals may develop pericarditis following what initially appears to be a routine viral illness.

Pericarditis: Complications

If there is enough fluid in the pericardial sac, there may be enough pressure on the outside of the heart to prevent it from functioning adequately. This may be a true medical emergency. The event needs to be managed by an invasive procedure called ‘pericardiocentesis’, wherein a long needle is inserted through the chest wall into the pericardial sac to remove the fluid.

If the heart or the pericardial sac (the space between the pericardium and the heart) gets damaged because of trauma, or due to the invasion of disease, then there may be scarring of the pericardial sac. This scarring may prevent the heart from expanding and thus functioning normally. Eventually, the heart may constrict and fail to dilate normally.

Untreated bacterial, tubercular or chronic pericarditis may also cause the pericardium to lose its elasticity, causing constriction of the heart. If the heart is unable to function normally, because of pericardial constriction, surgery to remove part of the pericardium may be required.

Pericarditis: Treatment

Mild cases of pericarditis are usually treated with rest and anti-inflammatory medications like aspirin and ibuprofen. Antibiotics may be given if pericarditis is due to a bacterial infection. A low-salt diet should be taken if one has constrictive pericarditis. Saturated fats, alcohol, and sugars that can increase inflammation and weaken the immune system should be avoided. Diet rich in vitamin A, C, E or beta-carotene help to strengthen the immune system.