Pericarditis: symptoms, causes and treatment

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Definition of pericarditis

What is pericarditis?

Pericarditis is one of the three types of inflammation of the heart, apart from endocarditis and myocarditis.

In contrast to myocarditis which is an inflammation of the heart muscle, pericarditis is a condition in which swelling and inflammation of the pericardium of the heart occurs. The pericardium is a two-layer fluid-filled membrane that covers the outside of the heart.

The function of the pericardium is to hold the heart in place, lubricate the heart, and protect the heart from infection or other diseases. In addition, this membrane also maintains the normal size of the heart when blood volume increases, so that the heart continues to function properly.

Pericarditis is generally an acute disease. Inflammation usually occurs suddenly and lasts several months. There is a chance that the inflammation may return years later

However, in some cases, this disease is also chronic or chronic. A person with chronic pericarditis will experience inflammation for a longer period of time, and requires more intensive treatment.

Most cases of inflammation of the lining of the heart are mild and go away on their own. However, inflammation has the risk of causing injury and thickening of the pericardium, so that heart function can potentially be impaired.

In severe cases, the doctor will provide certain medications, sometimes accompanied by surgical procedures to prevent complications.

How common is pericarditis?

Pericarditis is one of the most common types of pericardial disease, as well as one of the most common causes of chest pain.

This disease is more common in male patients than female patients. Although this condition is more common in patients aged 20-50 years, there are also many cases of inflammation of the lining of the heart in children and adolescents.

This disease can be overcome and prevented by controlling the existing risk factors. For more information regarding this disease, you can consult a doctor.

Signs & symptoms of pericarditis

Pericarditis is a type of heart disease that can be divided into several types, depending on the pattern of symptoms and how long the symptoms last.

Acute pericarditis

In the acute type, inflammation generally occurs less than 3 weeks. The most common signs and symptoms of pericarditis are sharp chest pain or pain, often complaining of a stabbing feeling in the back of the sternum or the left of the chest.

However, some patients also complain of pain that is continuous, pressing, and of varying intensity.

The pain may radiate to your right shoulder and neck. Often times, the pain will get worse when you cough, lie down, or take deep breaths. This is what makes this condition sometimes difficult to distinguish from the pain that occurs during a heart attack.

Chronic pericarditis

In the chronic type, signs and symptoms usually last longer and don't go away. Symptoms generally last for more than 3 months.

Chronic inflammation of the lining of the heart is usually associated with chronic inflammation in the body, so there may be a buildup of fluid around the heart (pericardial effusion). The most common symptom of chronic pericarditis is chest pain.

Regardless of the type, common signs and symptoms of pericarditis are:

• A sharp pain in the center or left of the chest.
• The pain gets worse when you take a deep breath.
• Shortness of breath while lying down.
• The heart beats irregularly.
• Fever, if the inflammation is caused by an infection.
• The body weakens and tires more easily.
• Dry cough.
• Swelling in the abdomen or legs

There are also symptoms of pericarditis that are similar to those of a heart attack that women often experience. The symptom of this pericarditis is pain in the back, neck and left shoulder.

There may be signs and symptoms not listed above. If you have concerns about certain symptoms, you can consult your doctor.

When to see a doctor

Seek medical help immediately if you experience symptoms such as chest pain, as there could be heart disease or blood cancer.

If you experience the symptoms that have been mentioned or if you have further questions, consult your doctor.

Each sufferer's body shows signs and symptoms that vary. To get the most appropriate treatment and according to your health condition, check any symptoms you feel at the doctor or the nearest health service center.

Causes of pericarditis

Under normal conditions, the two layers of the pericardial membrane that surrounds your heart contain a small amount of lubricating fluid. When pericarditis occurs, these membranes become inflamed. Friction on the inflamed area causes pain in the chest.

The cause of this condition is generally difficult to determine. In most cases, doctors usually have difficulty determining the underlying cause (idiopathic) or suspecting infection by certain pathogens.

This condition also sometimes occurs as a complication of a heart attack. This is because the heart muscle is irritated and has the potential to cause inflammation.

Even so, according to the British Heart Foundation, some of the possible causes of pericarditis are:

1. Idiopathic condition

As many as 26-86 percent of cases of this disease have no definite cause. However, scientists have recently suggested that the body's immune system factors may also play a role.

2. Infection

Infection can be caused by viruses, bacteria, and fungi or parasites. Viral infection is the most common cause. It is estimated that as many as 1-10% of cases of this disease are related to viral infections.

Some of the viruses that can cause pericarditis are:

• Coxsackievirus B
• Adenovirus
• Influenza A and B
• Enterovirus
• Epstein-Barr
• Human immunodeficiency virus (HIV)
• Herpes simplex virus (HSV)
• Hepatitis A, B, and C viruses

Apart from viral infections, bacteria are also the cause of 1-8% of cases of inflammation of the pericardium. Some of them are bacteria Streptococcus, Staphylococcus, Mycobacterium tuberculosis, Escherichia coli, Salmonella, and Haemophilus influenzae.

Fungi and parasites, such as Histoplasma, Blastomyces, Candida, Toxoplasma, as well Echinococcus also found in a minority of cases of inflammation of the pericardium.

3. Inflammatory disease or other inflammation

Other causes of pericarditis are inflammatory diseases, such as rheumatoid arthritis, systemic lupus erythematosus (SLE), scleroderma, or sarcoidosis.

Other diseases and conditions that can trigger inflammation are:

• Myocardial infarction
• Dressler's Syndrome
• Aortic dissection

In fact, another cause of pericarditis that may not be unexpected is heart surgery. Yes, this condition can be experienced by a heart disease patient who has just undergone surgery.

Risk factors for pericarditis

Pericarditis is a disease that can occur in almost anyone, regardless of age and racial group of the sufferer. However, there are several factors that can increase a person's risk for suffering from the disease.

It is important for you to know that having one or more risk factors does not mean that you will definitely get one of these types of heart disease.

In some cases, it is possible for a person to experience certain diseases or health conditions without any risk factors.

The following are risk factors that can trigger a person to develop pericarditis:

• Age

Inflammation of the pericardium is more common in patients aged 20 to 50 years. So, if you are in that age range, your risk for suffering from this disease is higher.

• Gender

The incidence of this disease is more common in male patients than female patients.

• Diseases (inflammation)

Patients with other inflammatory problems, such as rheumatoid arthritis, systemic lupus erythematosus (SLE), as well as scleroderma, are more at risk of developing inflammation of the pericardium.

• Certain diseases

People with certain diseases, such as HIV / AIDS, tuberculosis, and cancer, are more likely to experience this inflammation.

In addition, some metabolic problems, such as kidney failure, hypothyroidism, and hypercholesterolemia, can cause inflammation of the pericardium.

• Injury from an accident

If you have had a serious enough injury due to a certain accident, your risk of developing pericarditis is higher than that of ordinary people.

• Take certain drugs

Taking several types of drugs, such as phenytoin (an anti-seizure drug), warfarin, heparin (to thin the blood), and procainamide (a medicine for arrhythmias) can increase your chances of developing this disease.

However, if you do not have risk factors, it does not mean that you cannot get this disease. The above risk factors are for reference only. Consult your doctor for further details.

Complications of pericarditis

If this disease is not promptly treated, the symptoms will worsen and lead to health complications. Some of the complications of pericarditis are:

1. Cardiac tamponade

If there is too much fluid build up in the pericardium, there will be excess pressure on the heart. This results in reduced blood flow to and from the heart.

This condition is called cardiac tamponade. If not followed up immediately, this condition can lead to a drastic drop in blood pressure, even potentially leading to death.

2. Constrictive pericarditis

This condition is a rare complication of inflammation of the pericardium, in which there is thickening and permanent scarring of the pericardium.

When this complication occurs, the tissues in the heart cannot work properly. Breathing also has the potential to be disturbed, as well as swelling of the legs.

Diagnosis & treatment of pericarditis

The following information is not a substitute for medical instructions. Always consult your doctor.

Generally, the doctor will make a diagnosis with a thorough physical examination. Some questions about medical history, symptoms experienced, and family history of illnesses will be asked.

In addition, the doctor will also check the sound of your heartbeat with a stethoscope. Usually, doctors can detect the presence of pericarditis through a rubbing sound on the pericardium.

After that, your doctor will ask you to undergo some additional tests to get a more accurate diagnosis. A sample of fluid from your pericardium or blood will be taken to check for a bacterial or viral infection.

In addition, there are also additional tests that are usually performed to diagnose heart disease, including a diagnosis of heart attack, coronary heart disease, heart failure and various diagnoses for other heart diseases. Some additional tests for the diagnosis of pericarditis are:

1. Electrocardiogram (EKG)

In this test using an electrocardiogram, your doctor will attach wires to electrodes on your body to measure the electrical activity of your heart.

2. X-rays

With an x-ray, your doctor can analyze the size and shape of your heart. If the heart is enlarged, there may be a buildup of fluid in the pericardium.

3. Echocardiogram

This pericarditis test using an echocardiogram is a test that is performed using high-frequency sound waves. The goal is to produce images of your heart, including the buildup of fluid in the pericardium.

4. Computerized tomography (CT scan)

This x-ray technique produces more detailed images of the heart than ordinary x-rays. In addition, a CT scan can also help your doctor distinguish other causes of your chest pain, such as a pulmonary embolism or aortic dissection.

5. Magnetic resonance imaging (MRI scan)

This technique uses a magnetic field and radio waves to produce photos of your heart from various angles. MRI can also show a change in the size of the pericardium.

What are the treatments for pericarditis?

In common conditions, pericarditis is a heart disease that can heal on its own. Sufferers can rest at home and perform simple remedies. Treatment is usually done with medication, and in rare cases, surgical procedures are required.

1. Pain relievers

The first step in managing pericarditis is that the doctor will recommend resting until you feel better and the fever drops. Your doctor may also prescribe over-the-counter drugs, anti-inflammatory drugs to reduce pain and inflammation, such as aspirin and ibuprofen.

2. Colchicine (Colcrys, Mitigare)

This medication can help reduce inflammation in the body. Usually, this medication is given to treat acute inflammation, or to control persistent symptoms.

Colchicine can shorten the duration of symptoms, as well as reduce the risk of symptoms recurring at a later time. However, the use of this drug should be avoided by patients with liver and kidney disease.

3. Pericardiocentesis

If the disease worsens, you may need treatment for complications, such as cardiac tamponade and chronic constrictive inflammation.

Cardiac tamponade can be treated with pericardiocentesis, which is a needle or catheter tube inserted into the chest wall to remove excess fluid in the pericardium. This procedure will relieve pressure on the heart.

You will be given local anesthesia or anesthesia first before undergoing this procedure. Usually, this procedure is done in conjunction with an echocardiogram and ultrasound.

4. Pericardiectomy

If you are diagnosed with chronic constrictive inflammation, your doctor may recommend a surgical procedure to remove the pericardium. This procedure is called a pericardiectomy.

This procedure usually has to be done when the pericardium is thickened and stiff, so that the function of the heart in pumping blood is further impaired.

Home treatment for pericarditis

What are some lifestyle changes and home remedies to treat pericarditis?

The following lifestyle and medications can help you deal with pericarditis:

• Check up regularly to follow the progress of your disease and health conditions.
• Follow the doctor's instructions and advice.
• Get enough rest, avoid activities. and strenuous work that can make symptoms worse.

If you have any questions, consult with your doctor so they can understand the best solution for you.