Pericarditis: how does it affect my body?

Pericarditis is a condition which can produce profound pain and inflammation in the body, often linked to viral infections. Here to explain more about the condition, including its effects on the body and its diagnosis is revered consultant cardiologist Dr Teresa Castiello.

 What is pericarditis and how does it affect my body?

Pericarditis is inflammation of the pericardium, the thin sac that surrounds the heart. The pericardium works to protect the heart and keep it in place. When the pericardium is inflamed, it can cause chest pain, shortness of breath, and other symptoms. Pericarditis can affect people of all ages, but it is most common in young adults.

Pericarditis can affect the body in several ways. The inflammation can irritate the pericardium, producing pain. It can also cause fluid to build up around the heart, which can put pressure on the heart, making it difficult to beat and correctly expand.

In some cases, the pericardial inflammation can extend into the heart muscle, provoking concomitant myocarditis, while in severe cases, pericarditis can lead to pericardial tamponade, a clinical emergency.

Pericarditis can also be recurring, leading to chronic pericarditis and permanent thickening of the pericardium, with loss of its natural elasticity. This condition may compromise the correct filling and function of the heart (so-called ‘pericardial constriction).

What is the most likely cause of my symptoms?

The most common cause of pericarditis is a viral infection. However, the cause of the pericarditis largely depends on each individual’s medical history and other underlying conditions.

If you have recently had a viral infection, such as the common cold or the flu, it is likely that pericarditis has been provoked by the virus. On the other hand, If you have an autoimmune disease or other chronic medical condition, it is possible that your pericarditis is caused by the underlying condition.

Pericarditis can also be provoked by the following conditions:

• A bacterial infection, such as tuberculosis or pneumonia.
• Autoimmune diseases, such as rheumatoid arthritis or lupus.
• Certain medications or therapies.
• After a heart attack, surgery or traumatic injuries (so-called “ Dressler syndrome").

Unfortunately, in some cases, the cause of pericarditis is unknown.

What kinds of tests do I need to diagnose pericarditis?

It is crucial to share your symptoms and medical history with your cardiologist. They will also perform a physical exam, listening to your heart with a stethoscope.

If your doctor suspects pericarditis, they may order a number of tests, including:

• Blood tests: To check for signs of infection or inflammation.
• Electrocardiogram (ECG): To record the electrical activity of your heart. The ECG may have some typical sign of pericarditis with diffuse elevation of some electric segments
• Echocardiogram: to acquire images of your heart and surrounding structures. To check if there is any evidence of pericardial fluid or thickening.
• Chest X-ray: To look for signs of fluid buildup around the heart.

In some cases, your doctor may also refer you to a Cardiac MRI, especially if the pericarditis is recurrent or chronic and/or f  your doctor suspects that you are suffering from pericardial constriction.

In the case of large fluid collection around the heart, your doctor may perform a  pericardiocentesis. This is a procedure to remove fluid from the pericardial sac, with the double function of freeing the pericardial space and testing the fluid to better understand the underlying cause of your pericarditis.

What treatment approach do you recommend for pericarditis?

The treatment for pericarditis will depend on the underlying cause. In most cases, pericarditis can be treated with medication.

Common medications used to treat pericarditis include:
 

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as high doses of Ibuprofen or Aspirin to reduce inflammation and pain.
• Colchicine: A medication derived from a plant, colchicum autumnale, belonging to the Lily family, that can help to prevent recurrences of pericarditis.
• In selected cases corticosteroids can also be used: powerful anti-inflammatory medications that are commonly used in autoimmune disease.
• Anakinra: for severe recurrent pericarditis this medication can also be prescribed, but is it not needed for the most common and benign pericarditis.

If your pericarditis is caused by an infection, your doctor may prescribe antibiotics, while If your pericarditis is caused by an autoimmune disease or other chronic medical condition, the doctor may prescribe medications to manage your underlying condition.

In rare cases, pericarditis can cause serious complications, such as cardiac tamponade, a life-threatening condition that occurs when fluid builds up around the heart and compresses it. The development of cardiac tamponade will require immediate hospitalisation and treatment. In emergency cases, pericardiocentesis, an invasive procedure, is essential to remove fluid from the pericardial sac.

Furthermore, constrictive pericarditis may be treated with a surgical procedure such as a pericardial window.

How soon after I begin treatment can I expect improvement in my symptoms?

Most people experience improvement in their symptoms within a few days of starting treatment. However, it can take up to several weeks for the inflammation to completely resolve.

It is important to follow your doctor's instructions carefully and to take your medications as prescribed. You should also rest and avoid strenuous activity until your doctor says it is okay to resume your normal activities.

It is important to note that conclusion pericarditis is usually benign, but it is crucial that it is addressed and treated correctly and promptly. It is important to be assessed and treated by a cardiologist who is an expert in this particular area.

If you would like to book a consultation with Dr Castiello, do not hesitate to do so by visiting her Top Doctors profile today.