Pericarditis
Pericarditis is an inflammation of the protective sac surrounding the heart (pericardium), which is made up of connective tissue. Pericarditis can have a number of causes, may be associated with chest pain, and can usually be treated with medication. Many patients with pericarditis complain of shortness of breath, palpitations, and a stabbing pain behind the sternum (breastbone).
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What is pericarditis?
Pericarditis is a condition in which the connective tissue membrane (sac) around the heart becomes inflamed. This inflammation can be acute or chronic in nature. Pericarditis can develop as a result of infectious or non-infectious processes. It is frequently accompanied by pericardial effusion (fluid between the heart and pericardium) and, if treatment is delayed or interrupted before the infection has been cleared, the connective tissue can become thickened and calcified. Pericarditis can spread to neighboring layers of the heart and can cause potentially life-threatening complications.
What are the main symptoms?
- Stabbing pain behind the sternum (breastbone), which may worsen when breathing deeply or when coughing
- Shortness of breath
- Palpitations (racing heart)
- Fever
![[Translate to Englisch:] Perikaderguss - Immanuel Herzzentrum Brandenburg in Bernau - Perikarditis](/assets/_processed_/4/7/csm_immanuel-herzzentrum-brandenburg-in-bernau-perikarditis-perikaderguss_920498b902.webp "[Translate to Englisch:] Perikaderguss - Immanuel Herzzentrum Brandenburg in Bernau - Perikarditis")
What are the possible causes of pericarditis?
- Viruses (coxsackie A and B, adenovirus, echovirus)
- Bacteria (tuberculosis)
- Fungi (candida, aspergillus)
- Autoimmune diseases (rheumatoid arthritis, sarcoidosis, lupus erythematosus)
- Heart attack
- Cardiac surgery
- Cancer
- Kidney disease and kidney failure
- Trauma
Diagnosis of pericarditis
- Pericardial friction rub can be heard close to the ear during auscultation
- Chest x-ray - findings tend to be remarkable only with large effusions.
- Pericardiocentesis - if a bacterial infection is suspected, sampling of the pericardial fluid can help identify the causative agent, while the presence of abnormal cells may indicate a tumor.
- A variety of ECG changes
- Blood tests: evidence of infection
- Chest x-ray
- Definitive diagnostic tool: cardiac ultrasound: pericardial effusion?
Treatment for pericarditis
- Rest and avoidance of physical exertion
- Medication
- Pericardiocentesis (pericardial tap)
Avoidance of strenuous physical activity
Avoidance of strenuous physical activity and regular monitoring of vital parameters is crucial.
Medication
Drug-based treatment includes the use of anti-inflammatory agents such as ibuprofen, diclofenac and colchicine. Corticosteroids may also need to be administered in some cases. In cases of bacterial or fungal infections, the physician will prescribe antibiotics or antifungal agents.
Pericardiocentesis (pericardial tap)
Pericardiocentesis must be performed if cardiac function is impaired as a result of a large amount of fluid collecting inside the pericardial sac. The patient may even require cardiac surgery (pericardial window procedure).
If treated correctly, cases of acute pericarditis usually resolve completely. Untreated, however, pericarditis may become chronic, and can lead to pericardial calcification and hardening, and permanent damage to the heart muscle.