Dr. M.J. Bazos, MD. Patient Handout

PERICARDITIS

About Your Diagnosis
Pericarditis is inflammation of the pericardium. The pericardium is the fibrous, membranous sac that encases the heart. It helps hold the heart in place in the chest and helps lubricate the pumping of the heart. Inflammation in the pericardium can be caused by infection, myocardial infarction (heart attack), cancer, radiation, or allergic reactions. It may have no known cause. The inflammation may injure the membrane and cause scarring, which constricts the heart (constrictive pericarditis). It may also cause decreased blood flow from the heart. This decreased blood flow causes symptoms of heart failure (decreased pumping efficiency of the heart), including difficulty breathing and swelling in the tissues of the legs, feet, or abdomen (edema).

Living With Your Diagnosis
Symptoms include chest pain behind the sternum (breast bone) and pain with change in position or with deep breathing. You may have a fever if infection is the cause of pericarditis. Sometimes palpitations (rapid heartbeat) are felt. The diagnosis is made on the basis of clinical symptoms and findings at a physical examination. An electrocardiogram (ECG) and chest radiograph (x-ray) show evidence of the inflammation. An echocardiogram (ultrasound examination of the heart) may show fluid in the pericardial sac.

Treatment
Treatment focuses on the cause of the inflammation and the pain. Infections are managed with antibiotics. Pain is usually managed with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. Steroidal anti-inflammatory drugs may be used in more severe cases. If fluid in the pericardium affects the ability of the heart to function, an operation may be performed to cut a window in the membrane to allow the fluid to drain.

The DOs
•Take your medications as scheduled. Taking all prescribed antibiotics until completed is especially important to keep the infection from returning. The pain may last for several days after the antibiotics are completed, and repeat echocardiograms may be needed.

The DON’Ts
•Avoid strenuous exertion until after the symptoms have resolved.
•Do not drink alcohol if you are taking steroidal anti-inflammatory drugs.

When to Call Your Doctor
•If you have new or worsening chest pain or pain with deep breaths or changes in position.
•If you have severe stomach pain or vomiting of blood. You can take acetaminophen (eg, Tylenol) for pain even if you are already taking aspirin or anti-inflammatory drugs.