Pericarditis

Diagnosis  

Pericarditis diagnosis typically involves a healthcare provider conducting a physical examination and inquiring about symptoms and medical history. The provider will listen to heart sounds using a stethoscope placed on the chest and back, specifically to identify a pericardial rub, a distinct sound caused by the rubbing of the pericardium layers around the heart. Additionally, blood tests are commonly performed to check for indicators of heart attack, inflammation, and infection.  Additional diagnostic tests for pericarditis can include the following: 

• Electrocardiogram (ECG): Is a non–invasive test that records the electrical signals of the heart. It involves placing sticky patches with wires (electrodes) on the body, which are connected to a monitor. These electrodes capture the electrical activity responsible for the heartbeat. The recorded information is then displayed as waves on a monitor or on paper using a computer. 
• Chest X–ray: Is a diagnostic procedure that can reveal changes in the size and shape of the heart. By capturing images of the chest area, it helps in identifying whether the heart is enlarged. 
• Echocardiogram: Utilizes sound waves (ultrasound) to generate images of the heart in motion. It provides valuable information about the heart’s ability to pump blood effectively and can also detect fluid accumulation in the tissues surrounding the heart. 
• Cardiac computerized tomography (CT): Scans employ X–rays to produce detailed images of the heart and chest. This imaging technique is particularly useful in detecting heart thickening, which may indicate constrictive pericarditis. 
• Cardiac magnetic resonance imaging (MRI): Utilizes a combination of a magnetic field and radio waves to create cross–sectional images of the heart. It offers valuable insights into the presence of thickening, inflammation, or other changes in the thin tissues surrounding the heart.

Treatment  

The treatment approach for pericarditis is determined by the underlying cause and the severity of symptoms. In cases of mild pericarditis, it is possible for the condition to improve without any specific treatment. 

Medications 

Medications commonly prescribed to reduce inflammation and swelling associated with pericarditis include: 

• Pain relievers: Over–the–counter pain relievers like aspirin or ibuprofen (Advil, Motrin IB) are often effective in managing pericarditis pain. In some cases, prescription–strength pain relievers may be recommended. 
• Colchicine: This medication helps reduce inflammation throughout the body. Colchicine is often prescribed to control inflammation and prevent recurring episodes of pericarditis, which can happen weeks or even months later. It is important to note that individuals with liver or kidney disease should not take colchicine. Additionally, colchicine can interact with other drugs, so your healthcare provider will carefully review your medical history before prescribing it. 
• Corticosteroids: Corticosteroids are potent anti–inflammatory medications. If symptoms of pericarditis do not improve with other medications or if they recur, a corticosteroid like prednisone may be prescribed to alleviate inflammation. 

In cases where pericarditis is caused by a bacterial infection, treatment may involve the use of antibiotics and drainage if necessary. 

Surgeries or other procedures: 

When fluid accumulates between the layers of the pericardium, it can lead to a condition called pericardial effusion. If the fluid builds up rapidly, it can result in cardiac tamponade, which is a serious condition where the heart is compressed and cannot function properly. Cardiac tamponade is a medical emergency that requires immediate diagnosis and treatment. 

If pericarditis causes pericardial effusion, it may be necessary to perform a surgical intervention or another medical procedure to remove the fluid. Some of the surgeries or procedures used to treat pericarditis include the following: 

• Pericardiocentesis: This procedure involves using a sterile needle or a small tube (catheter) to remove and drain the excess fluid from the pericardial cavity.
• Pericardiectomy: If the sac surrounding the heart has become permanently rigid due to constrictive pericarditis, the entire pericardium may need to be surgically removed.