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Pericarditis -- Adult

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Definition

Pericarditis is irritation and swelling of the pericardium, which is the thin sac that surrounds the heart. Extra fluid that builds up between the two layers of the pericardium restricts the heart’s action.
Pericarditis
pericarditis
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Causes

The cause of pericarditis is often unknown. However, possible causes include:
  • Viral, bacterial, or fungal infection
  • Heart attack
  • Inflammatory diseases such as rheumatoid arthritis or lupus
  • Cancer that has spread from a tumor near the heart
  • Kidney failure
  • Injury or surgery affecting the chest, esophagus, or heart
  • Radiation treatment
  • Certain medications used to suppress the immune system

Risk Factors

Factors that increase your chance of getting pericarditis include:
  • A weakened immune system that is not able to fight off infections and other diseases
  • Any of the causes listed above

Symptoms

Chest pain is a common symptom of pericarditis, especially over the left side or center of the chest. It sometimes spreads to the neck and left shoulder. It is usually a sharp, stabbing pain. Deep breathing or lying down may worsen the pain. Sitting up may lessen it. Other symptoms may include:
  • Shortness of breath
  • Coughing
  • Fever and chills
  • Pain when swallowing
  • Weakness and fatigue

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. A stethoscope will be used to listen for a grating or rubbing sound in your heart. If the condition is severe, there may be a crackle sound in your lungs. The following tests may be performed:
Images of your heart may need to be taken. This can be done with:
Your bodily fluid may need to be tested. This can be done with:
  • Blood tests
  • Pericardiocentesis

Treatment

Treating pericarditis depends on the cause, if the cause is known. In many cases, when the cause is unknown or viral pericarditis is suspected, pain relievers and anti-inflammatory medications are given. In other cases, corticosteroids may be given. If the condition is caused by a bacterial infection, antibiotics are used.
If the fluid is seriously affecting the heart’s ability to pump, the fluid may need to be removed through pericardiocentesis, which is the same procedure used for testing. In rare cases, surgery may be performed.
Depending on the cause of the pericarditis, the illness can range from mild to life-threatening. Acute inflammatory pericarditis usually subsides with treatment within a few weeks or months. However, pericarditis caused by chronic inflammatory diseases, like lupus or rheumatoid arthritis , may last longer or tend to recur.
If you are diagnosed with pericarditis, follow your doctor's instructions .

Prevention

There is no known way to prevent pericarditis.

RESOURCES

American Heart Association http://www.heart.org

National Heart, Lung and Blood Institute http://www.nhlbi.nih.gov

CANADIAN RESOURCES

Canadian Cardiovascular Society http://www.ccs.ca

The College of Family Physicians of Canada http://www.cfpc.ca

References

Acute pericarditis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 3, 2012. Accessed March 25, 2013.

Pericarditis. Texas Heart Institute website. Available at http://www.texasheart.org/HIC/Topics/Cond/pericard.cfm . Updated October 2012. Accessed March 25, 2013.

What is pericarditis? American Heart Association website. Available at http://www.heart.org/HEARTORG/Conditions/More/What-is-Pericarditis%5FUCM%5F444931%5FArticle.jsp . Updated February 27, 2013. Accessed March 25, 2013.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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