Signs of Pericarditis (Heart sac inflammation)

Description

The pericardium is a sac that surrounds the heart. There is a small amount of fluid in this sac. Inflammation of the sac and/or fluid causes pericarditis. The following can cause the disorder: cardiac surgery or heart attack (Dressler's syndrome), viral infections, autoimmune diseases (Rheumatoid arthritis, Lupus, Scleroderma, Sarcoidosis), cancer, kidney failure, hypothyroidism, and certain medications (dilantin, procainamide, hydralazine). Too much fluid in the sac can be life threatening.

Symptoms

Chest pain, chest pain that decreases with sitting forward, feet and leg swelling , anxiety, breathing difficulty when lying down, dry cough, fatigue, fever exercise intolerance.

Tests

A history and physical exam will be performed. Tests to diagnose the pericarditis and identify the cause will be done and include: echocardiogram, ESR (erythrocyte sedimentation rate), autoimmune blood test, and possibly a CT scan.

Standard Workup

CBC
Chem 12
Troponin
X-Ray
EKG
CT Scan

Treatment

The cause of pericarditis must be identified and reversed or treated aggressively. Treatment specific for pericarditis includes: pain medications such as acetaminophen (Tylenol), antibiotics for bacterial pericarditis, antifungal medications for fungal pericarditis, aspirin or nonsteroidal anti-inflammatory medications/NSAIDs (ibuprofen/Motrin or Advil, naproxen/Naprosyn), steroids, colchicine, and diuretics to remove excess fluid in the pericardial sac. If the excess fluid develops rapidly a needle may need to be emergently inserted into the sac for drainage (pericardiocentesis). Surgery may also be necessary. For additional information contact the National Heart, Lung and Blood Institute Health Information Center at: http://www.nhlbi.nih.gov or call (301)592-8573.