Pericarditis is inflammation of the pericardium, which is the thin sac that surrounds the heart and the roots of the great vessels. There is normally a small amount of fluid between the inner and outer layers of the pericardium. When the pericardium becomes inflamed, the amount of fluid between its two layers increases, compressing the heart and interfering with its ability to function properly.
Typically, the cause of pericarditis is unknown, but may include these causes:
- a viral, bacterial or fungal infection
- heart attack
- cancer spreading from a nearby tumor in the lung, breast or the blood
- sometimes it may be a secondary symptom of rheumatoid arthritis, lupus (systemic lupus erythematosus), or kidney failure
How is pericarditis treated?
Pericarditis is usually treated with analgesics or anti-inflammatory drugs to relieve pain. When excess fluid seriously affects the heart’s action, it may be drawn off with a needle. In some cases, surgery may be required.
Acute inflammatory pericarditis usually lasts two to six weeks. About 20% of pericarditis patients have a recurrence within months or, sometimes, years later. Each recurrence tends to be less severe until the episodes finally stop.
Signs, symptoms & indicators of Pericarditis
Pain in chest or left side
Counter Indicators
Asbsence of chest or left sided pain
Difficulty swallowing
Moderate/mild unexplained fevers
Having a slight/having a moderate/having a high fever
Chest pain when breathing out or chest pain when breathing in or chest pain when breathing
The most common symptom of pericarditis is chest pain. The pain is predominantly felt below the breastbone (sternum) and/or below the ribs on the left side of the chest and, occasionally, in the upper back or neck. Breathing causes the lungs and heart to move in the chest and rub against the irritated pericardium, worsening the pain. Pain may worsen when patients lie down and may improve when they sit up and lean forward. Changes in position can increase or decrease pressure on and irritation of the inflamed pericardium.
Conditions that suggest Pericarditis
(History of) pericarditis
Counter Indicators
Absence of pericarditis
Risk factors for Pericarditis
Lupus, SLE (Systemic Lupus Erythromatosis) / Risk
Sometimes pericarditis may be a secondary symptom of lupus (systemic lupus erythematosus).
Gluten Sensitivity / Celiac Disease
A few patients with celiac disease have been treated with a gluten- free diet which led to clinical and EKG improvement of recurrent pericarditis. [Lancet: pp.1021-2, 1981]
Chronic / Hidden Infection
Mycoplasma pneumonia is a good example of how a stealth pathogen can move out of it’s typical environment and into other parts of the body and begin causing other diseases. While residing in the respiratory tract and lungs, Mycoplasma pneumonia remains an important cause of pneumonia and other airway disorders, such as tracheobronchitis, pharyngitis and asthma. When this stealth pathogen hitches a ride to other parts of the body, it is associated with non-pulmonary manifestations, such as blood, skin, joint, central nervous system, liver, pancreas, and cardiovascular syndromes and disorders. This single stealth pathogen has been discovered in the urogenital tract of patients suffering from inflammatory pelvic disease, urethritis, and other urinary tract diseases. It has been discovered in the heart tissues and fluid of patients suffering from cardititis, pericarditis, tachycardia, hemolytic anemia, and other coronary heart diseases.
Rheumatoid Arthritis
Sometimes pericarditis may be a secondary symptom of rheumatoid arthritis.
Kidney Failure
Sometimes pericarditis may be a secondary symptom of kidney failure.
Recommendations for Pericarditis
Conventional Drugs / Information
In a study of nine patients with recurrent pericarditis resistant to traditional therapy it was found that all had a positive response with colchicine at a dose of one mg/day. These patients had experienced relapses despite treatment with indomethocin, acetylsalicylic acid, or prednisone. With colchicine treatment prednisone was discontinued in all patients between 2 to 6 weeks. The colchicine was continued. A mean follow-up of 24.3 months showed no recurrences in
any patient. These results are encouraging but due to the small sample in this study larger trials are warranted. [Circulation, 1990;82: pp.1117-1120]
Key
| Weak or unproven link |
| Strong or generally accepted link |
| Proven definite or direct link |
| Weakly counter-indicative |
| Very strongly or absolutely counter-indicative |
| May do some good |
Glossary
Cancer
Refers to the various types of malignant neoplasms that contain cells growing out of control and invading adjacent tissues, which may metastasize to distant tissues.
Rheumatoid Arthritis
A long-term, destructive connective tissue disease that results from the body rejecting its own tissue cells (autoimmune reaction).
Chronic Renal Failure
(CRF) Irreversible, progressive impaired kidney function. The early stage, when the kidneys no longer function properly but do not yet require dialysis, is known as Chronic Renal Insufficiency (CRI). CRI can be difficult to diagnose, as symptoms are not usually apparent until kidney disease has progressed significantly. Common symptoms include a frequent need to urinate and swelling, as well as possible anemia, fatigue, weakness, headaches and loss of appetite. As the disease progresses, other symptoms such as nausea, vomiting, bad breath and itchy skin may develop as toxic metabolites, normally filtered out of the blood by the kidneys, build up to harmful levels. Over time (up to 10 or 20 years), CRF generally progresses from CRI to End-Stage Renal Disease (ESRD, also known as Kidney Failure). Patients with ESRD no longer have kidney function adequate to sustain life and require dialysis or kidney transplantation. Without proper treatment, ESRD is fatal.
Anti-inflammatory
Reducing inflammation by acting on body mechanisms, without directly acting on the cause of inflammation, e.g., glucocorticoids, aspirin.
Acute
An illness or symptom of sudden onset, which generally has a short duration.
Celiac Disease
(Gluten sensitivity) A digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten. Common symptoms include diarrhea, increased appetite, bloating, weight loss, irritability and fatigue. Gluten is found in wheat (including spelt, triticale, and kamut), rye, barley and sometimes oats.
Electrocardiogram
A test that shows a tracing of the electrical conduction of the heart.
Tracheobronchitis
Inflammation of the mucous membrane of the trachea and bronchi.
Asthma
A lung disorder marked by attacks of breathing difficulty, wheezing, coughing, and thick mucus coming from the lungs. The episodes may be triggered by breathing foreign substances (allergens) or pollutants, infection, vigorous exercise, or emotional stress.
Nervous System
A system in the body that is comprised of the brain, spinal cord, nerves, ganglia and parts of the receptor organs that receive and interpret stimuli and transmit impulses to effector organs.
Cardiovascular
Pertaining to the heart and blood vessels.
Tachycardia
Excessively rapid heart rate.
Hemolytic Anemia
Anemia caused by excessive destruction of red blood cells.