Pericarditis is an inflammation of the pericardium. Pericarditis is usually acute – it develops suddenly and may last up to several months. If you could see and touch it, the membrane around the heart would look red and swollen, like the skin around a cut that becomes inflamed. Sometimes excess fluid develops in the space between the pericardial layers and causes a pericardial effusion (buildup of excess fluid around the heart).
Chest pain symptoms associated with pericarditis can be described as:
a) Sharp and stabbing (caused by the heart rubbing against the pericardium)
b) May increase with coughing, swallowing, deep breathing or lying flat
c) Can be relieved by sitting up and leaning forward
d) You also may feel the need to bend over or hold your chest to breathe more comfortably.
Other Symptoms:
a) Pain in the back, neck or left shoulder
b) Difficulty breathing when lying down
c) A dry cough
d) Anxiety or fatigue
Include:
1) Chest X-ray: Shows evidence of enlargement of the heart and congestion of the lungs.
2) Electrocardiogram (ECG or EKG): Shows changes in your normal heart rhythm that may indicate you have pericarditis.
3) Echocardiogram (echo): Shows the heart function and may show evidence of fluid or pericardial effusion around the heart. It will also show the classic signs of constrictive pericarditis when present (including stiffening or thickening of the pericardium that constricts the heart’s normal movement).
4) Cardiac MRI and CT scan: Show excess fluid in the pericardium or signs of pericardial inflammation using a special imaging agent called gadolinium. These tests may also show a thickened pericardium or compression of the heart from the thickened pericardium.
5) Cardiac catheterization: Provides hemodynamic information about the filling pressures within the heart in order to confirm a diagnosis of constrictive pericarditis.
6) Laboratory (blood) tests: Can be used to make sure you are not having a heart attack, to evaluate the heart’s function, test the fluid in the pericardium and determine the underlying cause of the pericarditis. Often, the sedimentation rate (ESR) or C reactive protein levels (markers of inflammation) are elevated. Other laboratory tests may include evaluation for autoimmune diseases.
Include:
• Medication: is all that is needed to clear up the inflammation and surgery is not usually necessary.
• Pericardiocentesis: a procedure to drain the excess fluid with a catheter. The doctor will use echocardiography to safely guide the placement of a large needle and catheter into the pericardium to remove excess fluid.
• Pericardial window: If the fluid cannot be drained with a needle, then a surgical procedure called a pericardial window is performed.
• Pericardiectomy: is the surgical treatment of pericarditis that involves the removal of a portion of the pericardium. Surgery is rarely done for pain control of recurrent pericarditis.
Consult at Aadil Hospital for medical and surgical treatment.
