Acute Pericarditis: Symptoms and Treatment
Acute pericarditis is an inflammatory condition that affects the pericardium, the two-layered sac surrounding the heart. This condition can lead to significant discomfort and potentially severe complications if not promptly diagnosed and treated. This article delves into the symptoms, diagnosis, and treatment of acute pericarditis, providing a comprehensive understanding of this medical condition.
What is Acute Pericarditis?
Acute pericarditis refers to the sudden onset of inflammation of the pericardium. The pericardium has two layers: the visceral pericardium, which is in direct contact with the heart, and the parietal pericardium, which forms the outer fibrous sac.
Between these layers is a small amount of lubricating fluid that allows the heart to move smoothly within the chest cavity. Inflammation can lead to an increase in this fluid and subsequent pericardial effusion, further complicating the clinical picture.
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Get A Second OpinionCauses of Acute Pericarditis
The etiology of Acute cholecystitis causes is diverse, encompassing infectious, non-infectious, and idiopathic causes. The most common causes include:
Infections: Bacterial infections like tuberculosis or viral infections such as HIV can lead to pericarditis. Although rare, fungal infections and parasitic infections can also cause it.
Cancer: Pericarditis can sometimes be caused by cancer, either directly from pericardial cancer or when tumors spread to the heart from other areas.
Immune System Conditions: Diseases like lupus, rheumatoid arthritis, or Sjögren’s syndrome can cause inflammation of the pericardium, leading to acute pericarditis.
Hormonal Issues: Disorders such as hypothyroidism (low thyroid function) and ovarian hyperstimulation syndrome may increase the risk of developing pericarditis.
Trauma: Physical injuries to the chest, such as blunt force or penetrating wounds (e.g., knife or bullet injuries), can cause irritation and inflammation of the pericardium.
Heart or Circulatory Problems: Issues like heart attacks or aortic dissection (tearing of the aorta) can lead to acute pericarditis.
Symptoms of Acute Pericarditis
Chest pain is the common symptom of acute cholecystitis signs. It often feels sharp or stabbing, but can also be dull, achy, or pressure-like. The pain is typically felt behind the breastbone or on the left side of the chest and may:
- Spread to the left shoulder, neck, or both shoulders.
- Get worse with coughing, lying down, or deep breathing.
- Improve when sitting up or leaning forward.
Other symptoms of pericarditis include:
- Cough
- Fatigue or weakness
- Swelling in the legs or feet
- Low-grade fever
- Pounding or racing heartbeat (palpitations)
- Shortness of breath, especially when lying down
- Swelling of the abdomen
Acute Pericarditis symptoms can be classified based on its symptoms and duration:
- Acute pericarditis starts suddenly and lasts up to 4 weeks. It may be hard to distinguish from a heart attack.
- Recurrent pericarditis happens 4 to 6 weeks after an acute pericarditis, with no symptoms in between.
- Incessant pericarditis lasts 4 to 6 weeks but less than 3 months, with symptoms continuing during that time.
- Chronic constrictive pericarditis develops slowly and lasts longer than 3 months.
Diagnosis of Acute Pericarditis
Acute Pericarditis ECG
The electrocardiogram (ECG) is a crucial diagnostic tool for acute pericarditis. Typical ECG changes in acute pericarditis progress through four stages:
- Stage I: Diffuse ST-segment elevation and PR-segment depression.
- Stage II: Normalization of ST and PR segments.
- Stage III: T-wave inversion.
- Stage IV: Resolution of T-wave changes.
These ECG findings help differentiate acute pericarditis from other causes of chest pain, such as myocardial infarction.
Laboratory Tests
Laboratory tests can support the diagnosis of acute pericarditis. Elevated inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are common. Cardiac biomarkers like troponin may also be elevated, indicating myocardial involvement.
Imaging Studies
Echocardiography is essential for assessing pericardial effusion and evaluating the presence of cardiac tamponade. Chest X-rays can reveal cardiomegaly if significant pericardial effusion is present, but they are generally less specific.
Treatment for Acute Pericarditis
Pharmacological Treatment
The acute cholecystitis treatment aims to reduce inflammation, relieve pain, and prevent complications.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) like ibuprofen or aspirin are used to control inflammation and ease pain.
- Colchicine is often added to prevent recurrence.
- Corticosteroids are used when NSAIDs are ineffective or contraindicated but are linked to higher recurrence rates.
- If a bacterial infection is identified, appropriate antibiotics will be prescribed.
Non-Pharmacological Treatment
- Rest: Patients are advised to rest until symptoms resolve to prevent exacerbation of inflammation.
- Monitoring: Regular follow-up is crucial to monitor the resolution of symptoms and detect any potential complications.
Treatment of Complications
- Pericardial Effusion: Small effusions may resolve spontaneously, but large or symptomatic effusions may require pericardiocentesis to prevent cardiac tamponade.
- Cardiac Tamponade is a medical emergency requiring immediate pericardiocentesis or surgical intervention to relieve the pressure on the heart.
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Book an AppointmentComplications of Acute Pericarditis
complications of acute cholecystitis can arise if acute pericarditis is not adequately managed. These include:
- Recurrent Pericarditis: This can occur in up to 30% of cases, often within weeks to months of the initial episode.
- Cardiac Tamponade: Accumulation of fluid under pressure can impair cardiac filling and output, leading to a life-threatening situation.
- Constrictive Pericarditis: Chronic inflammation can lead to fibrosis and thickening of the pericardium, restricting heart movement and causing heart failure symptoms.
Prevention of Acute Pericarditis
- Treat Infections Early: Seek prompt medical care for bacterial infections to avoid complications, especially to your heart.
- Protect Against Injuries: Use seatbelts and safety gear to prevent chest injuries that could lead to pericarditis.
- Follow Medical Advice: Stick to your doctor's recommendations and medications to lower your risk, especially if you have underlying health conditions.
Frequently Asked Questions
What are the symptoms of acute pericarditis?
Symptoms include chest pain, shortness of breath, and fatigue.
What causes acute pericarditis?
It can be caused by viral infections, heart attack, or autoimmune diseases.
How is acute pericarditis treated?
Treatment involves anti-inflammatory medications, pain relief, and in severe cases, surgery.
How is acute pericarditis diagnosed?
Diagnosis is made through an echocardiogram, ECG, and blood tests.
What are the complications of acute pericarditis?
Complications can include pericardial effusion or chronic pericarditis.
What are the 4 criteria for acute pericarditis?
The 4 criteria for acute pericarditis include: chest pain, pericardial friction rub, characteristic ECG changes, and evidence of pericardial effusion or inflammation.
Does pericarditis show on ECG?
Yes, acute pericarditis shows characteristic ECG changes, including ST-segment elevation, PR-segment depression, T-wave inversion, and later T-wave normalization.
