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Pericarditis

What is pericarditis?

  • Pericarditis is an inflammation (swelling) of the pericardium, which is the sac that covers the heart. The pericardium has an inner and outer layer, and a small amount of fluid between these layers. The job of the pericardium is to act as a protective cover against infection and the spread of cancer. It also prevents too much movement of the heart and decreases rubbing between the heart and other organs.
  • When the pericardium swells, the fluid between the two layers increases. This squeezes the heart and the blood vessels, affecting the way the heart beats and pumps blood. You may have sudden chest pain, often painful enough to need medical help right away.

What causes pericarditis?

An infection by a germ called a virus is the most common cause of pericarditis, but for some people the cause is unknown. The following are other causes:

  • Infection: Germs such as bacteria and tuberculosis.
  • Trauma: Injury to the chest as a result of an accident or a hard blow.
  • Medicine: Certain medicines can cause pericarditis.
  • Radiation: A chest x-ray may cause irritation and swelling of the pericardium.
  • Other diseases: A heart attack, chronic renal failure, rheumatoid arthritis, AIDS, or cancer spreading from nearby organs.

What are the signs and symptoms of pericarditis?

The most common symptom is sudden and severe (very bad) chest pain. It is often described as:

  • Sharp and stabbing.
  • Felt behind the breastbone, at times spreading to the neck, jaw, and left shoulder.
  • Worse when breathing in, coughing, or when lying down. Relief is felt upon sitting up and leaning forward.
  • Lasting several hours to several days.
Other signs and symptoms may include:
  • Fever.
  • Feeling like your heart is pounding or racing.
  • Nausea (upset stomach).
  • Vomiting (throwing up).
  • Hoarseness of voice.

How is pericarditis diagnosed?

You may need any of the following tests:

  • Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  • Computerized tomography scan: This is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your heart.
  • Magnetic resonance imaging: This test is also called an MRI. MRI allows caregivers to see inside your body. During the MRI, pictures are taken of your heart.
  • Echocardiogram:
    • This test is also called an echo. It is a type of ultrasound, using sound waves to show pictures of the size and shape of your heart. An echo also looks at how your heart moves when it is beating. These pictures are seen on a TV-like screen.
    • This test is done while lying down on your back. Clear jelly will be squirted on your chest to help the ultrasound sensor slide easily. The sensor will be rubbed across your chest to see your heart from different angles. You may hear a barking or whooshing noise, which is the sound of your blood flow. Caregivers may ask you to pedal a bike during the test (exercise echo) or you may get medicine before the test to increase blood flow to your heart muscle (stress echo). This test can tell how well your heart is pumping. An echo can also find problems, such as fluid around the heart or problems with your heart valves.
  • 12-lead ECG: This test, also called an EKG, helps caregivers look for damage or problems in different areas of the heart. Caregivers may need to prepare your skin by shaving off some hair, or cleaning it with a gritty lotion. Sticky pads are placed on your chest, arms, and legs. Each sticky pad has a wire that is hooked to a machine or TV-type screen. A short period of electrical activity in your heart muscle is recorded. Caregivers will look closely for certain problems or changes in how your heart is working. This test takes about 5 to 10 minutes. It is important that you lie as still as possible during the test. You may need this test more than once.
  • Pericardiocentesis: This procedure is used to take a sample of fluid from the pericardium with a needle. The fluid is sent to the lab for tests.
  • Pericardial biopsy: A sample of the pericardium is taken and sent to the lab for tests.

How is pericarditis treated?

You may need any of the following treatments:

  • Medicines:
    • Antibiotics: This medicine is given if pericarditis is caused by a bacteria.
    • Antituberculotic medicine: Antituberculotic medicine may be given to kill the germ that causes tuberculosis (TB).
    • Aspirin: Aspirin may be given to help decrease pain, swelling, and fever.
    • Non-steroidal anti-inflammatory drugs: Also called NSAIDs, this medicine decreases pain caused by swelling.
    • Steroids: Steroids may be given to decrease swelling of the pericardium.
  • Pericardiocentesis: This is a procedure in which a needle is used to remove extra fluid from the pericardium.
  • Surgery: Surgery called a pericardiectomy may be done to remove a part of, or all of the pericardium.

Where can I find support and more information?

Having pericarditis is a life-changing disease for you and your family. Accepting that you have the condition may be hard. You and those close to you may feel anxious or frightened. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group with other people who have pericarditis. Ask your caregiver for contact information for support groups. Contact the following for more information:

  • American Heart Association National Center
    7272 Greenville Avenue
    Dallas, TX 75231-4596
    Phone: 1-800-242-8721
    Web Address: http://www.americanheart.org
  • American College of Cardiology
    9111 Old Georgetown Road
    Bethesda, MD 20814
    Phone: 1-301-897
    Phone: 1-800-253-4636
    Web Address: http://www.acc.org/

Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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