| Pericarditis is inflammation of the pericardium, a | | | | conditions. Potential sources of cardiac perforation |
| membrane that surrounds the heart and its major | | | | include central line placement, pacemaker insertion, |
| blood vessels. Pericarditis can be caused by | | | | cardiac catheterization, sternal bone marrow |
| infection, heart attack, autoimmune disorders, | | | | biopsies, and pericardiocentesis. |
| chest trauma, cancer, kidney failure, or drugs. | | | | Pericarditis usually occurs in flare-ups, but it may |
| Pericarditis most often affects men aged 20-50. | | | | be the presenting manifestation. Constrictive |
| Pericarditis may be acute or chronic. Heart attack | | | | pericarditis is a very difficult therapeutic problem. |
| (see post-MI pericarditis) and myocarditis can | | | | Diuretics may be used to remove excess fluid |
| cause pericarditis, as can radiation therapy to the | | | | accumulated in the pericardial sac. Bacterial |
| chest and medications that suppress the immune | | | | pericarditis must be treated with antibiotics. Fungal |
| system. Acute pericarditis due to tuberculosis | | | | pericarditis is treated with antifungal agents. |
| begins insidiously, sometimes without obvious | | | | Medicines, such as aspirin, ibuprofen, or other |
| symptoms of lung infection. It may produce fever | | | | nonsteroidal anti-inflammatory drugs (NSAIDs), are |
| and symptoms of heart failure, such as | | | | commonly used to manage the pain and |
| weakness, fatigue, and difficulty breathing. Cardiac | | | | inflammation. Acute inflammatory pericarditis |
| tamponade may occur. Pericarditis can be | | | | usually lasts one to three weeks and doesn't lead |
| misdiagnosed as myocardial infarction, and vice | | | | to further problems. About 20 percent of |
| versa. Pericarditis is more common in adolescents | | | | pericarditis patients have a recurrence within |
| and young adults. In a recent study, Merce et al | | | | months or, rarely, within years. Pericarditis is |
| found no difference in etiology, clinical course, and | | | | treated with bed rest, diuretics, and digitalis, but |
| prognosis between elderly and younger patients | | | | definitive treatment requires surgery to strip the |
| with moderate and large pericardial effusions. | | | | thickened pericardial lining from the heart. |
| Pericarditis occurs in up to 15% of patients who | | | | Treatment for Pericarditis Tips |
| have acute myocardial infarctions (heart attacks). | | | | 1. Analgesics or anti-inflammatory drugs are given |
| There is also a late form of post-heart-attack | | | | to relieve pain. |
| pericarditis, called Dressler's syndrome, that occurs | | | | 2. Antibiotics are also prescribed if the pericarditis |
| weeks to months after the heart attack. Chronic | | | | is due to a bacterial infection. |
| pericarditis occurs when the pericardial | | | | 3. Tamponade is treated by draining the fluid from |
| inflammation does not resolve within a few | | | | the pericardial sac, usually via a tiny catheter. |
| weeks. Constrictive pericarditis occurs when a | | | | 4. Removing the fluid relieves the pressure on the |
| chronically inflamed pericardial sac sticks to the | | | | heart, and restores normal cardiac function almost |
| heart muscle, squeezing it constricting it. A CT or | | | | immediately. |
| MRI scan can also help to diagnose chronic or | | | | 5. Pericarditis is treated with bed rest, diuretics, |
| constrictive pericarditis, by showing the thickening | | | | and digitalis. |
| of the pericardial lining associated with these | | | | |