Pericarditis

What is Pericarditis?

• The inflammation of the thin, two-layered fluid-filled sac that surrounds the heart (pericardium) is known as Pericarditis.
• This condition leads to friction between two layers when the heartbeats.
• There are three different types of Pericarditis:
• Acute Pericarditis: Inflammation develops suddenly and lasts for three weeks.
• Chronic Pericarditis: Inflammation develops in a slow process and lasts more than 6 months.
• Constrictive Pericarditis: Pericardium layer thickens and forms the scar tissue and makes the heart work normally.
• In most cases, pericarditis will be acute.

What are the causes of pericarditis?

• Viral infection: Most commonly due to gastrointestinal virus
• A bacterial infection like tuberculosis
• Fungal infection
• Infection from parasite
• Autoimmune disorders like lupus, scleroderma, or rheumatoid arthritis
• Chest injury
• Kidney failure
• Hypothyroidism
• Carcinoma
• Genetic diseases
• Certain medicines like phenytoin, Warfarin, heparin, or procainamide

What increases the risk of developing pericarditis?

• Infection
• Thyroid problems
• Following a heart attack or heart surgery
• Following radiation therapy
• Percutaneous treatment like cardiac catheterization or radiation ablation therapy

What are the symptoms of pericarditis?

• Chest pain is a common symptom of pericarditis and may get worse when patient cough, swallow, breathe or lie flat
• Sharp and stabbing due to friction between the two layers
• Pain in the back, neck or left shoulder
• Anxiety
• Fatigue
• Swelling in feet, legs or ankle and abdomen
• Irregular heartbeat
• Shortness of breath

What are the complications of pericarditis?

• Cardiac tamponade: This condition is due to fluid in the pericardium that leads to improper functioning of heart and dramatic drop in blood pressure.
• Chronic constrictive pericarditis: Permanent thickening and scarring of two-layered pericardium lead to severe swelling of abdomen and legs, shortness of breath.

How is pericarditis diagnosed?

• Electrocardiogram
• Echocardiogram:
  To identify the presence of fluid around the heart
  To determine emergency surgical treatment
  To differentiate ate a type of pericarditis involvement
• Cardiac catheterization:
  To remove excess fluid(pericardial effusion) around the heart
  To differentiate the type of pericarditis
  To identify the blocks in blood vessels of the heart

• CT scan:
• Cardiac MRI:

How is pericarditis treated?

• To reduce inflammation and swelling of legs or abdomen
• Over the counter drugs like aspirin or ibuprofen
• Colchicine: To reduce inflammation during acute pericarditis. Contraindicated during liver or kidney damage
• Corticosteroids like prednisolone
• Antibiotics during pericarditis caused by a bacterial infection
• Pericardiocentesis: This procedure involves a needle or catheter to drain excess fluid in the  in the pericardial cavity

Pericardiectomy:

This procedure involves the removal of entire pericardium by open-heart surgery for chronic constrictive pericarditis