Acute vs. Chronic Pericarditis
Pericarditis cases fall into one of two large categories: acute and chronic. Acute pericarditis makes up the vast majority of reported cases, and usually lasts less than a few weeks. Chronic or recurrent pericarditis, on the other hand, usually lasts six months or longer [source. Mayo Clinic].
Pericarditis generally results from heart attacks, infections or immunological disorders. Chest trauma -- caused by an accident or injury, or an invasive cardiac procedure or resuscitation -- is also a potential cause. In rare instances, pericarditis can result from radiation treatment or in response to certain drugs, such as anticoagulants and penicillin [source: Czapsky]. In the case of a heart attack, a patient may suffer from a delayed onset of pericarditis, known as Dressler's syndrome, in which the body can mistakenly attack its own tissue [source: Mayo Clinic].
If you suspect you may be suffering from pericarditis, make an appointment to see your doctor immediately. Expect a battery of questions regarding your and your family's medical histories. They will likely listen to your heart and possibly order tests, including X-rays, CT scans, MRI, blood work or even an electrocardiogram (EKG).
There is a broad range of treatment for pericarditis. What your doctors recommend will depend on the severity of your condition, but the primary goal is to reduce inflammation and eradicate the any underlying infection. In most instances, if your doctors suspect a viral or bacterial infection, they will likely order a round of antibiotics, aspirin or non-steroidal anti-inflammatory medications.
If the symptoms persist for more than a week, your doctors may order an echocardiogram, which can not only determine the amount of fluid in the pericardium, but can also indicate whether the fluid is putting pressure on the heart -- a condition known as cardiac tamponade -- or if the tissue that makes up the pericardium is compromised and becoming stiff (a condition known as constrictive pericarditis) [source: WebMD].
In cases of persistent or chronic pericarditis that fail to respond to lower-dose medications, doctors may opt to treat with colchicine or powerful corticosteroids to reduce inflammation. If the excess fluid in the pericardium doesn't diminish with initial treatment, doctors may suggest a pericardiocentesis. Surgeons can relieve pressure on the patient's heart by using a sterile needle and tube to remove excess fluid from the pericardium via a needle and tube (similar to amniocentesis). Tests on the extracted fluid can also shed some light on the cause of the inflammation, which can be another diagnostic tool for the doctors.
In the vast majority of cases, the pericarditis will clear up within a week to 10 days. However, in the case of chronic or recurrent pericarditis, inflammation and the resulting symptoms can linger for weeks on end. Though rarer, chronic pericarditis can also be much more dangerous. Left untreated, pericarditis can lead to a host of more serious, and even potentially fatal, conditions.
Chronic pericarditis is often linked to any number of other ailments, including leukemia, tuberculosis, lupus, rheumatoid arthritis, kidney failure, rheumatic fever, malfunctioning thyroid and AIDS/HIV infection. This persistent swelling of the pericardial fluid (pericardial effusion) can rob the pericardial sheath of its elasticity, leading to severe cardiopulmonary problems.
- Berezovskaya, Sabina. "What is the Role of Colchicine in recurrent Pericarditis." Clinical Correlations, The New York University Internal Medicine Blog. March 14, 2009. (Feb. 8, 2012)http://www.clinicalcorrelations.org/?p=1090
- Czapsky, Abigail. "Pericarditis: Symptoms and Treatment." Helium. May 13, 2008. (Feb. 6, 2012) http://www.helium.com/items/980924-pericarditis-symptoms-and-treatment
- Glanville, Rosemarie. "Pericarditis: Symptoms and Treatment." Helium. April 7, 2008. (Feb. 5, 2012) http://www.helium.com/items/980514-pericarditis-symptoms-and-treatment
- HealthScout. "Pericarditis." USA Today. (Feb. 7, 2012) http://www.healthscout.com/ency/68/620/main.html
- Huber, Mark. "Pericarditis: Symptoms and Treatment." Helium. April 8, 2008. (Feb. 6, 2012) http://www.helium.com/items/981352-pericarditis-symptoms-and-treatment
- Kohnle, Diana. "Health Tip: What's Pericarditis?" HealthDay. April 26, 2007. (Feb. 8, 2012) http://www.dentalplans.com/articles/14012/health-tip-what-s-pericarditis.html
- Mayo Clinic. "Pericarditis." MayoClinic.com. April 29, 2011. (Feb. 5, 2012) http://www.mayoclinic.com/health/pericarditis/DS00505
- MedlinePlus. "Pericarditis - bacterial." National Institutes of Health. May 6, 2010 (Feb. 9, 2012) http://www.nlm.nih.gov/medlineplus/ency/article/000173.htm
- Orzechowseki, Ray, DMD. Personal interview. Feb. 12, 2012.
- Park, Robin. "Pericarditis." HealthWise/RevolutionHealth. May 2, 2007. (Feb. 6, 2012) http://www.revolutionhealth.com/conditions/heart/pericarditis/about?section=section_00
- Thomas, Cameron. "Pericarditis: Symptoms and Treatment." Helium. April 8, 2008. (Feb. 6, 2012) http://www.helium.com/items/980806-pericarditis-symptoms-and-treatment
- WedMD. "Pericarditis – Topic Overview." WebMD.com. April 5, 2011. (Feb. 8, 2012) http://www.webmd.com/heart-disease/tc/pericarditis-topic-overview
- Wedro, Benjamin, MD. "Pericarditis." MedicineNet.com (Feb. 6, 2012) http://www.medicinenet.com/pericarditis/article.htm