Acute Pericarditis: Symptoms, Causes, Treatment

What are the symptoms of acute pericarditis?

Acute pericarditis is inflammation of the pericardium, the thin membrane that surrounds the heart. The symptoms of acute pericarditis can vary but may include:

1. Chest pain: The most common symptom of acute pericarditis is sharp, stabbing chest pain, often behind the breastbone or on the left side of the chest. The pain may worsen when lying down, coughing, or swallowing and may be relieved by sitting up or leaning forward.
2. Pericardial friction rub: A pericardial friction rub is a scratching or grating sound heard with a stethoscope over the chest. It occurs when the inflamed pericardial layers rub against each other during the heart’s contractions.
3. Shortness of breath: Difficulty breathing or shortness of breath, especially when lying down or with exertion, can occur due to the inflammation affecting the heart’s ability to pump effectively.
4. Fever and chills: Some people with acute pericarditis may develop a low-grade fever and chills, especially if the inflammation is due to an infection.
5. Fatigue: Feeling tired or fatigued is common, especially if the pericarditis is causing other symptoms such as chest pain or shortness of breath.
6. Cough: A persistent cough, especially if it is dry and nonproductive, can occur with acute pericarditis.
7. Swelling: In some cases, swelling of the legs or abdomen (edema) may occur due to fluid buildup caused by pericarditis.
8. Other symptoms: Other symptoms that may occur with acute pericarditis include a rapid or irregular heartbeat (palpitations), lightheadedness or fainting (syncope), and a general feeling of discomfort or malaise.

It’s important to note that the symptoms of acute pericarditis can be similar to those of other heart and lung conditions, so it’s important to see a healthcare provider for an accurate diagnosis if you experience any of these symptoms.

What are the causes of acute pericarditis?

Acute pericarditis can have several causes, including:

1. Viral infections: Viral infections, such as Coxsackievirus, influenza, or HIV, are a common cause of acute pericarditis.
2. Bacterial infections: Bacterial infections, such as tuberculosis or staphylococcus, can cause acute pericarditis, although they are less common than viral infections.
3. Autoimmune disorders: Autoimmune disorders, such as lupus or rheumatoid arthritis, can cause the body’s immune system to attack the pericardium, leading to inflammation.
4. Post-infarction pericarditis: Pericarditis can occur after a heart attack (myocardial infarction) due to inflammation in the pericardium.
5. Trauma: Trauma to the chest, such as a car accident or blunt force trauma, can cause inflammation of the pericardium.
6. Certain medications: Some medications, such as procainamide, hydralazine, or isoniazid, can cause drug-induced pericarditis.
7. Other medical conditions: Medical conditions such as kidney failure, cancer, or HIV can increase the risk of developing pericarditis.

In many cases, the exact cause of acute pericarditis is unknown (idiopathic). However, regardless of the cause, the inflammation of the pericardium can lead to chest pain and other symptoms. Treatment for acute pericarditis typically focuses on relieving symptoms and addressing the underlying cause, if known.

What is the treatment for acute pericarditis?

The treatment for acute pericarditis depends on the underlying cause and the severity of symptoms. In many cases, acute pericarditis resolves on its own with rest and over-the-counter pain relievers. However, if the pericarditis is caused by an infection or other underlying condition, treatment may be necessary. Here are some common treatments for acute pericarditis:

1. Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, such as ibuprofen or indomethacin, are often used to reduce inflammation and relieve pain. These medications are usually the first line of treatment for acute pericarditis.
2. Colchicine: Colchicine is another medication that may be used to reduce inflammation and prevent recurrent episodes of pericarditis.
3. Corticosteroids: In cases of severe or persistent pericarditis, corticosteroids such as prednisone may be prescribed to reduce inflammation. However, corticosteroids are generally used with caution due to the risk of side effects.
4. Antibiotics: If the pericarditis is caused by a bacterial infection, antibiotics may be prescribed to treat the infection.
5. Pain relievers: Over-the-counter pain relievers, such as acetaminophen, may be used to relieve chest pain associated with pericarditis.
6. Rest: Resting and avoiding strenuous activities can help reduce symptoms and promote healing.
7. Pericardiocentesis: In cases of pericarditis with significant fluid buildup (pericardial effusion), a procedure called pericardiocentesis may be performed to drain the fluid from the pericardium.
8. Treatment of underlying conditions: If the pericarditis is caused by an underlying medical condition, such as an autoimmune disorder, kidney failure, or cancer, treatment of the underlying condition may help resolve the pericarditis.

It’s important to follow your healthcare provider’s recommendations for treatment and follow-up care. Acute pericarditis can sometimes lead to complications, such as pericardial effusion or constrictive pericarditis, so it’s important to seek medical attention if you experience symptoms of pericarditis.

What age group and gender is most prone to acute pericarditis?

Acute pericarditis can occur at any age, but it is most commonly seen in adults between the ages of 20 and 50. It is slightly more common in men than in women. However, pericarditis can occur in people of any age, including children and older adults. The risk of developing acute pericarditis may be higher in certain populations, such as those with a history of autoimmune disorders, infections, or other medical conditions.

What is the prognosis for people with acute pericarditis?

The prognosis for people with acute pericarditis is generally good, especially for those with no underlying structural heart disease. Most cases of acute pericarditis resolve with appropriate treatment, and the majority of people recover completely without long-term complications.

However, the prognosis can vary depending on several factors, including the underlying cause of the pericarditis, the severity of symptoms, and how well the person responds to treatment. Complications of acute pericarditis, such as pericardial effusion or constrictive pericarditis, can affect the prognosis.

With prompt diagnosis and appropriate treatment, most people with acute pericarditis can expect to recover within a few weeks to months. It’s important for people with acute pericarditis to follow their healthcare provider’s recommendations for treatment and follow-up care to ensure the best possible outcome.