Pericarditis - A Heart-threatening Disease

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What is Pericarditis ?  Pericarditis is a condition in which the thin, saclike tissue that surrounds the heart becomes inflamed and swollen (pericardium). Sharp chest pain is a common pericarditis symptom. The pericardium's inflamed layers press against one other, creating chest pain.  Pericarditis is typically minor and self-resolving. More severe cases may be treated with medication or, in rare occasions, surgery. Early detection and treatment of pericarditis can assist to lower the risk of long-term consequences.

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Symptoms The most common pericarditis symptom is chest discomfort. It has a sharp or stabbing sensation most of the time. Some patients, however, experience dull, achy, or pressure-like chest pain. Pain from pericarditis is most commonly felt behind the breastbone or on the left side of the chest. The discomfort could be caused by : • The left shoulder and neck are affected. • Coughing, reclining down, or taking a big breath make it worse. • Improve your sitting or leaning forward skills. Pericarditis can also cause the following signs and symptoms: • • • • • • •

Cough Fatigue, a general feeling of weakness, or being ill are all symptoms of being unwell. Swelling of the legs Fever of a low intensity Heart pounding or racing (heart palpitations) You may have shortness of breath while lying down. The stomach swells (abdomen) www.cardium.in


The symptoms of pericarditis vary depending on the type. Pericarditis is divided into different categories based on the pattern of symptoms and the length of time that they last. • Acute pericarditis is a type of pericarditis that develops quickly and lasts for three weeks or less. Future episodes are possible. It can be difficult to tell the difference between acute pericarditis and pain after a heart attack. • After an acute pericarditis episode, recurrent pericarditis develops four to six weeks later, with no symptoms in the interim. • Persistent pericarditis usually lasts four to six weeks, but no longer than three months. The signs and symptoms do not stop. • Chronic constrictive pericarditis has a slow start and lasts for more than three months.

When should you see a doctor ? • If you acquire new chest discomfort symptoms, seek medical attention right once. • Pericarditis has several symptoms that are similar to those of other heart and lung diseases. If you experience any form of chest pain, it's critical to see a doctor for a comprehensive examination. www.cardium.in


Causes Pericarditis is notoriously difficult to diagnose. It's possible that no reason has been discovered (idiopathic pericarditis). Pericarditis can be brought on by a number of things, including: • After a heart attack or heart surgery, the immune system responds to the damage to the heart (Dressler syndrome, also called postmyocardial infarction syndrome or postcardiac injury syndrome) • COVID-19, for example, is an infection. • Lupus and rheumatoid arthritis are examples of inflammatory diseases. • A heart or chest injury is a serious condition that requires immediate medical attention. • Kidney failure and cancer are two more chronic health issues. www.cardium.in


Complications Pericarditis can be diagnosed and treated early, which minimises the risk of consequences. Pericarditis can lead to the following complications: • A accumulation of fluid around the heart (pericardial effusion) - Further heart issues may result from the fluid buildup. • The lining of the heart thickens and scars (constrictive pericarditis) - Long-term pericarditis can cause chronic thickening and scarring of the pericardium in certain persons. The alterations make it impossible for the heart to fill and empty properly. Severe swelling of the legs and abdomen, as well as shortness of breath, are common symptoms of this rare consequence. • Fluid buildup puts pressure on the heart (cardiac tamponade) - This potentially fatal disease stops the heart from adequately filling. Blood pressure drops dramatically when less blood leaves the heart. Cardiac tamponade necessitates immediate medical attention.

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Prevention Pericarditis does not have a specific treatment. Taking the following precautions to prevent infections, on the other hand, may assist to minimise the risk of heart inflammation: • Until they've recovered, stay away from folks who have a viral or flu-like sickness - If you have symptoms of a viral infection, try to stay away from others. • Maintain a healthy level of hygiene - Hand washing on a regular basis can help prevent the spread of sickness. • Vaccines are highly recommended - Maintain current vaccinations, including those that protect against COVID-19, rubella, and influenza, all of which can cause myocarditis. Rarely, the COVID19 vaccine can induce pericarditis (inflammation of the outer heart lining) and heart muscle inflammation, especially in males aged 12 to 17. Consult your doctor about the advantages and disadvantages of immunizations. www.cardium.in


Diagnosis A health care practitioner would usually examine you and ask questions about your symptoms and medical history to diagnose pericarditis. To listen to heart sounds, a stethoscope is usually placed on the chest and back. A pericardial rub is a sound produced by pericarditis. When the two layers of the sac enclosing the heart (pericardium) brush against each other, a noise is produced. Typically, blood tests are performed to look for indicators of a heart attack, inflammation, or infection. Other tests for pericarditis diagnosis include :  Electrocardiogram (ECG) An electrocardiogram (ECG) is a painless and rapid examination that records electrical signals in the heart. A monitor is connected to sticky patches (electrodes) with wires attached. They keep track of the electrical impulses that cause the heart to beat. The data is stored in a computer and displayed as waves on a monitor or on paper.  Chest X-ray An X-ray of the chest can reveal changes in the size and shape of the heart. It can aid in the detection of an enlarged heart. www.cardium.in


 Echocardiogram Ultrasound waves create images of the beating heart. An echocardiography can reveal how effectively the heart pumps blood and whether fluid has accumulated in the tissue surrounding the heart.  Computerized tomography (CT) scan of the heart X-rays are used to create pictures of the heart and chest in cardiac CT scans. The test can detect cardiac thickening, which could indicate constrictive pericarditis.  Magnetic resonance imaging of the heart (MRI) Cardiac MRI creates cross-sectional images of the heart using a magnetic field and radio waves. An MRI examination of the thin tissue surrounding the heart can indicate thickening, inflammation, or other alterations.

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Treatment Treatment for pericarditis is determined on the origin and degree of symptoms. Pericarditis that is mild may improve without treatment.  Medications Anti-inflammatories and anti-swelling medications are frequently administered. Here are several examples: • Pain relievers Pain from pericarditis is commonly managed with over-the-counter analgesics such aspirin or ibuprofen (Advil, Motrin IB, others). Pain medications with a prescription strength are also an option. • Colchicine (Colcrys, Mitigare) This medication works by reducing inflammation in the body. It's used to treat acute pericarditis and recurrent symptoms. If you have liver or renal illness, you should avoid taking this medication. Colchicine can also cause interactions with other medications. Before administering colchicine, your doctor will thoroughly examine your medical history. • Corticosteroids Corticosteroids are powerful anti-inflammatory drugs. If pericarditis symptoms do not improve with previous drugs or if symptoms reappear, a corticosteroid such as prednisone may be recommended. Antibiotics and, if necessary, drainage may be used to treat pericarditis caused by a bacterial infection.

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 Surgical treatments or other procedures If pericarditis causes fluid to build up around the heart, the fluid may need to be drained through surgery or another method. Pericarditis can be treated with surgery or other techniques such as: • Pericardiocentesis A sterile needle or a tiny tube (catheter) is used to extract and drain excess fluid from the pericardial cavity during this treatment. • The pericardium is removed (pericardiectomy). If the sac enclosing the heart is chronically stiff owing to constrictive pericarditis, the entire pericardium may need to be removed.  Home remedies and a healthy lifestyle Rest and over-the-counter pain medications, given as instructed by your healthcare professional, may be all that's required for mild pericarditis. Avoid excessive physical activity and competitive sports while you recover. Pericarditis symptoms might be triggered by such exercise. Inquire with your doctor about how long you should rest.

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