Pericarditis (heart sac inflammation)

Description The pericardium is ...

Description

The pericardium is a sac that surrounds the heart. There is a trace amount of fluid in this sac. Pericarditis is inflammation of the sac and it can result in accumulation of additional fluid around the heart. The most common cause is a virus. Pericarditis can also occur after cardiac surgery or heart attack (this is called Dressler's syndrome). Other causes are autoimmune diseases (Rheumatoid arthritis, Lupus, Scleroderma, Sarcoidosis), cancer, kidney failure, and certain medications (Dilantin, procainamide, hydralazine). Too much fluid in the sac can be life threatening.

Symptoms

Chest pain, chest pain that decreases with sitting forward, feet and leg swelling , anxiety, breathing difficulty when lying down, dry cough, fatigue, fever exercise intolerance.

Tests

Common tests used for diagnosis and treatment

Workup:
A history and physical exam will be performed. Chest x-ray and electrocardiogram (ECG or EKG) are usually done. Echocardiogram (ultrasound of the heart) confirms the diagnosis. Blood tests may help suggest a cause. The fluid may need to be sampled to know a final diagnosis.

Tests:
Complete blood count (CBC), Comprehensive metabolic panel (CMP), CT Scan, Electrocardiogram (EKG), Troponin, X-ray

Other Specific Tests: Echocardiogram, ESR (erythrocyte sedimentation rate), Autoimmune blood tests

Specialists:
Cardiology, Pediatric Cardiology

Treatment

Pericarditis may require a hospital stay for treatment. Pain medications in the family of nonsteroidal anti-inflammatory medications/NSAIDs (ibuprofen/Motrin or Advil, naproxen/Naprosyn) are helpful to treat mild cases, as is the medicine colchicine. Steroids may be used for autoimmune pericarditis. Fluid around the heart may need to be sampled or drained through a needle or a narrow tube. Surgery to cut a hole in the sac around the heart (to allow drainage) may also be necessary.