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What is it about ?
The heart is located in a sac (pericardium) which is made of a strong double wall. The deep leaflet is attached to the myocardium and the superficial leaflet moves all around it. Between the two walls, a small amount of liquid allows the membranes to slide relative to each other, making it easier for the heart to contract. The pericardium protects the heart from external influences and keeps it in its place.
Pericarditis is inflammation of the pericardium, with the inner lining of the sac swelling and becoming rough. The walls then have a harder time rubbing against each other, causing pain.
Inflammation of the pericardium can have many causes:
- an infection (viral, bacterial or fungal);
- a connective tissue disorder (eg rheumatoid arthritis);
- a tumor ;
- severe heart failure;
- damage to the pericardium itself (after an operation or an accident, for example);
- a side effect of certain medications, such as certain antibiotics and chemotherapy;
- after radiation therapy to the chest and heart area.
In most cases, there is no specific cause for the problem.
How to recognize it?
The most common symptom is a sharp, shooting pain in the chest. Usually the pain does not radiate, which is the case with a myocardial infarction.
Often there are signs of infection, such as fever, tired and a lack of appetite.
Pericarditis is a condition that can easily come back.
How is the diagnosis made?
On auscultation of the heart, we can sometimes hear a murmur characteristic. The electrocardiogram (ECG) shows characteristic abnormalities and an increase in inflammatory factors is observed in the blood. The chest x-ray is often normal, but suggests an enlarged heart. Based on these results, the doctor may refer you to a heart specialist (cardiologist) for an ultrasound, a ultrasound examination of the heart. The cardiologist can see if there is fluid in the pericardium.
What can you do ?
Seek medical attention immediately if chest pain occurs. It may indeed be a myocardial infarction for example. A few simple tests can allow the doctor to draw certain conclusions.
What can your doctor do?
Most of the time, treatment can be done at home. In some cases, hospitalization is required. Treatment for pericarditis involves taking anti-inflammatory drugs for two weeks.
If it is a relapse, treatment will be continued for one month. Colchicine (a special anti-inflammatory) is also added to the treatment for three months, or six months if it relapses. If the result is insufficient, the doctor may consider prescribing cortisone on a gradually decreasing schedule. However, the use of cortisone increases the risk of relapse.
In the event of significant fluid effusion, it is exceptionally possible to drain it with a needle placed in the pericardium.
The possible causal condition is also treated. The doctor will prescribe antibiotics for bacterial infections.
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