Causes, Symptoms, Treatment and Tests For Diagnosis of Pericarditis

Submitted on March 27, 2012

Pericarditis refers to a condition where the tissue layers that surround the heart get inflamed. The heart has around it thin membrane which is called as the pericardium. Pericarditis occurs when the pericardium is irritated and swollen. Pericarditis can be acute either when it comes on suddenly or when the symptoms develop gradually. This would happen mainly if the symptoms persist for a longer period of time.

Tests Recommended

Certain tests will be carried out to determine whether the person is suffering from pericarditis or not. The different pericarditis tests include:-

  • EKG (electrocardiogram): This test enables doctor to look at any areas of the heart that may be damaged. If the pericardium is inflamed, it will affect the normal electrical impulses of the heart. An electrocardiogram will help to determine if there is any abnormal electrical impulse.
  • Chest x-ray: A chest x-ray will show up any changes in the size of the heart. Pericarditis may make the heart look larger than it usually is.
  • Echocardiography: This is a kind of ultrasound which uses sound waves and allows doctors to view the heart. It can show up problems such as fluid around the heart.
  • Cardiac CT: A cardiac CT or a cardiac computerized tomography scan (CT or CAT scan) shows clearer pictures of the heart as compared to a chest x-ray.
  • Cardiac MRI: During a cardiac magnetic resonance imaging test, cross sectional images are taken of the heart which can reveal changes in the pericardium.
  • Other possible tests include blood tests, a pericardial biopsy and Pericardiocentesis.

Causes

The various pericarditis causes are listed below.

  • Idiopathic: Many times, doctors are unable to ascertain the cause of pericarditis. Doctors suspect that complications from viral infections are the reason for the pericarditis occurring.
  • A bacterial infection or a fungal infection could also lead to pericarditis.
  • Pericarditis could also be due to certain diseases such as tuberculosis, cancers such as leukemia, rheumatic fever, autoimmune disorders, AIDS or the HIV infection, as well as hypothyroidism.
  • Trauma to the heart or to the chest as a result of a mechanical injury or an accident could also lead to pericarditis.
  • Heart attacks could also lead to pericarditis. This could be due to either antibodies forming after the heart attack or due to underlying heart muscle being damaged and irritated after the heart attack. Antibody formation after heart surgery could also give rise to pericarditis.
  • Lupus and other systematic inflammatory disorders could also cause pericarditis.
  • Side effects of certain medications have also been linked to pericarditis.
  • Health problems like kidney failure are also responsible for this heart condition.
  • Other pericarditis causes include connective tissue disease, Scleroderma, metabolic diseases, radiation therapy to the chest, myocarditis, and Dressler’s Syndrome.

Symptoms

Pericarditis symptoms depend on the type of pericarditis that a person is suffering from. However, chest pain is the most common of all pericarditis symptoms. Once again, the type and intensity of chest pains the person experiences will depend on whether he or she has acute or chronic pericarditis. Do keep in mind that pericarditis symptoms are similar to symptoms experienced with other heart or lung conditions. It is therefore imperative that medical help be sought so that a correct diagnosis and treatment be started immediately. Given below is an overview of the usual pericarditis symptoms.

The chest pain which is symptomatic of pericarditis can be described as either a sharp and stabbing pain in the left side of the chest or behind the breastbone. This type of pain is most often felt by people who suffer from acute pericarditis. Some sufferers of acute pericarditis on the other hand report that their chest pain is duller and varies in intensity. This pain may increase when a person is lying down flat, breathing deeply, swallowing or coughing. Relief is found by sitting up and bending over. Other pericarditis symptoms include:-

  • Shortness of breath while lying down
  • Fatigue
  • A dry cough
  • Nausea
  • Swelling of the legs or abdomen - this swelling could be a sign of constrictive pericarditis. The heart is usually compressed in this case and the blood then goes back into the lungs, legs and abdomen which results in the swelling.
  • An overall sense of weakness
  • A low grade or mild fever, , usually 38-39C (100.4-102.2F)
  • Anxiety
  • Pain in the back, left shoulder or the neck

Treatment

Pericarditis treatment involves the use of medication or medical procedures as prescribed by the medical professional who is treating you. If medication is recommended, you may be advised to take either antibiotics, Antituberculotic medicine, Non-steroidal anti-inflammatory drugs (NSAIDs), or steroids. Mild pain relievers may also be prescribed to manage and control the pain as well as to reduce the inflammation. Medical procedures could involve either pericardiocentesis (a procedure where the excess fluid is drained) or even a pericardiectomy where the pericardium will be removed.

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