What is Pericarditis? What is Pericarditis? Updated:Jul 5,2016 Pericarditis is inflammation of the pericardium, two thin layers of a sac-like tissue that surrounds the heart, holds it in place and helps it work. A small amount of fluid keeps the layers separate so that there’s no friction between them. A common symptom of pericarditis is chest pain , caused by the sac’s layers becoming inflamed and possibly rubbing against the heart. It may feel like pain from a heart attack. If you have chest pain, call 9–1–1 right away because you may be having a heart attack . Overview Pericarditis can be attributed to other factors, including viral, bacterial, fungal, and other infections. Other possible causes are heart attack or heart surgery , other medical conditions, injuries and medicines. Pericarditis can be acute, meaning it happens suddenly and typically doesn't last long, or chronic,” meaning it develops over time and may take longer to treat. Both types of pericarditis can disrupt your heart's normal rhythm or function and possibly, though rarely, lead to death.

Outlook Most of the time, pericarditis is mild and clears up on its own with rest or simple treatment. Sometimes, to prevent complications, more intense treatment is needed. Recovery from pericarditis may take a few days to weeks or even months. Other Names for Pericarditis Idiopathic pericarditis (no known cause) Acute pericarditis Chronic effusive pericarditis and chronic constrictive pericarditis (forms of chronic pericarditis) Recurrent pericarditis Causes of Pericarditis The cause of pericarditis is often unknown, though viral infections are a common cause. Pericarditis often occurs after a respiratory infection. Chronic, or recurring pericarditis is usually the result of autoimmune disorders such as lupus, scleroderma and rheumatoid arthritis, disorders in which the body's immune system makes antibodies that mistakenly attack the body's tissues or cells.

Other possible causes of pericarditis are: Heart attack and heart surgery Kidney failure, HIV/AIDS, cancer, tuberculosis, and other health problems Injuries from accidents or radiation therapy Certain medicines, like phenytoin (an antiseizure medicine), warfarin and heparin ( blood-thinning medicines ), and procainamide (a medicine to treat irregular heartbeats ) Who Is at Risk for Pericarditis? Pericarditis affects people of all ages, but men 20 to 50 years old are more likely to develop it than others. Among those treated for acute pericarditis, 15 to 30 percent may get it again, with a small number eventually developing chronic pericarditis. This content was last reviewed March 2016.

Also in this section: Myocarditis/Pericarditis - body, last, viral, contagious, causes Myocarditis/Pericarditis Myocarditis/Pericarditis Photo by: claudio Myocarditis (my-oh-kar-DYE-tis) is inflammation of the heart muscle, and pericarditis (per-ih-kar-DYE-tis) is inflammation of the smooth sac surrounding the heart. KEYWORDS for searching the Internet and other reference sources Cardiomyopathy Pericardium What Are Myocarditis and Pericarditis? Myocarditis, or inflammation of the muscular walls of the heart, is most commonly caused by viruses, however, it can also be caused by bacteria, parasites, and fungi. Other causes of the condition include radiation, chemicals, cocaine use, and prescription medications. Conditions that affect several parts of the body, such as autoimmune diseases * , also can be associated with both myocarditis and pericarditis. When the pericardium (per-ih-KAR-dee-um), the smooth, double-layered sac-like covering that surrounds the heart, becomes inflamed—known as pericarditis—fluid usually accumulates in the space between its layers.

As the amount of fluid increases, the buildup puts pressure on the beating heart and can limit its ability to function. Many of the same infections that cause myocarditis can cause pericarditis as well, and the two often appear together. In addition to the infectious causes of pericarditis, heart surgery or a heart attack * can lead to an inflamed pericardium and accumulation of fluid around the heart. How Common Are Myocarditis and Pericarditis? Myocarditis and pericarditis are uncommon complications of many infectious diseases. Many cases of myocarditis are mild and go undetected when the person is sick. In fact, it is difficult to determine exactly how many people develop myocarditis or pericarditis. However, some evidence of myocarditis is found in 1 to 4 percent of autopsies * . In almost all of these cases, there were no symptoms of the disease while the person was alive. * autoimmune (aw-toh-ih-MY-OON) diseases are diseases in which the body's immune system attacks some of the body's own normal tissues and cells. * heart attack is a general term that usually refers to a sudden, intense episode of heart injury.

It is usually caused by a blockage of a coronary artery, which stops blood from supplying the heart muscle with oxygen. * autopsies (AW-top-seez) are examinations of bodies after death to look for causes of death or the effects of diseases. Are Myocarditis and Pericarditis Contagious? Neither condition is directly contagious. However, many of the organisms that cause infections that can lead to myocarditis or pericarditis are spread from person to person by coughing or sneezing. It is not clear why myocarditis or pericarditis develops in some people but not in others. A combination of the infection, a person's genes * , and an individual's immune response probably determines who will develop these conditions. What Are the Signs and Symptoms of Myocarditis and Pericarditis? Because both conditions can seriously affect the heart's function, they may lead to signs and symptoms of heart failure. Patients with myocarditis may experience fever, rapid heartbeat, extreme tiredness, difficulty breathing, and chest pain that can range from mild to severe, sometimes with heart attack-like intensity. In serious cases, congestive heart failure * , fainting, and, sometimes, sudden death can occur.

Pericarditis often is accompanied by sharp chest pains, trouble breathing, and pain when taking a deep breath. These conditions usually improve when the patient is sitting or standing rather than lying down. Other symptoms may include dry cough, extreme tiredness, fever, rapid heartbeat, and chills. How Are Myocarditis and Pericarditis Diagnosed? A doctor will suspect myocarditis based on symptoms and a physical exam. For instance, a rapid heartbeat, fluid in the lungs, and swollen ankles and feet may point to heart failure, which can occur with myocarditis. The history of the patient's illness is another important clue, as the patient often has had symptoms of a viral infection within the previous 2 weeks to 6 months. To assess the heart's condition, the doctor may order any of a variety of tests. Although a chest X ray often appears normal in the early stages of the illness, it may show an enlarged heart or fluid-filled lungs. An electrocardiogram * (EKG) may show evidence of heart inflammation and can help identify a heart attack as the possible cause of the symptoms. An echocardiogram * may show the decreased heart function seen in myocarditis.

Blood tests that reveal inflammation of the heart muscle are often abnormal in people with myocarditis and can help in making the diagnosis. A biopsy * of a piece of heart muscle can provide a definitive diagnosis. Other tests may be done to identify a specific virus or other infectious organism, but in many cases the exact cause of the inflammation is never found. * genes (JEENZ) are chemical structures composed of deoxyribonucleic acid (DNA) that help determine a person's body structure and physical characteristics. Inherited from a person's parents, genes are contained in the chromosomes found in the body's cells. * congestive (kon-JES-tiv) heart failure, or heart failure, is a condition in which a damaged or overworked heart cannot pump enough blood to meet the oxygen and nutrient needs of the body. People with heart failure may find it hard to exercise due to the insufficient blood flow, but many people live a long time with this condition. * electrocardiogram (e-lek-tro-KAR-dee-o-gram), also known as an EKG, is a test that records and displays the electrical activity of the heart.

* echocardiogram (eh-ko-KAR-dee-uh-gram) is a diagnostic test that uses sound waves to produce images of the heart's chambers and valves and blood flow through the heart. * biopsy (BI-op-see) is a test in which a small sample of skin or other body tissue is removed and examined for signs of disease. * computerized tomography (kom-PYOO-ter-ized toe-MAH-gruh-fee) or CT, also called computerized axial tomography (CAT). is a technique in which a machine takes many X rays of the body to create a three-dimensional picture. * magnetic resonance imaging, or MRI, uses magnetic waves, instead of X rays, to scan the body and produce detailed pictures of the body's structures. To diagnose pericarditis, doctors look for signs of fluid around the heart. During a physical exam, physicians also listen for a rubbing sound that can be heard when the pericardial sac is inflamed. If enough fluid is present, the heart may appear enlarged on a chest X ray.

The fluid itself can be seen on an echocardiogram, a computerized tomography * (CT) scan, or a magnetic resonance imaging * (MRI) scan. An EKG can be helpful in making the diagnosis as well. How Are Myocarditis and Pericarditis Treated? Myocarditis and pericarditis may be difficult or impossible to prevent, but prompt recognition and treatment of these conditions will improve the chances of recovery. With both myocarditis and pericarditis, doctors strive to identify and treat the underlying cause, reduce the inflammation, and improve the heart's function. These are serious conditions that usually require hospitalization once the patient has developed detectable symptoms. Anti-inflammatory medicines such as aspirin, nonsteroidal anti-inflammatory medications, or corticosteroids * may be prescribed to reduce inflammation. Patients also may receive medicine to ease pain and diuretics * to remove excess fluid from the body. Depending on the cause and the complications of the inflammation, other treatments may be necessary as well, including antibiotics and medications that control heart rhythm problems and improve heart function.

Some cases of pericarditis may require pericardiocentesis (per-ih-KAR-dee-o-sen-tee-sis), or the removal of fluid from the pericardial sac with a needle. This relieves pressure on the heart and collects fluid for tests. In chronic or recurrent cases, the doctor may recommend surgery to cut or remove part of the pericardium. During recovery, the patient's activity usually is restricted, and doctors typically recommend diet changes such as eating less salt. Cases of myocarditis and pericarditis may last from 2 weeks to 3 months, although some people never fully recover their prior heart function. What Are Some Complications of Myocarditis and Pericarditis? Complications of these conditions can be very serious. The heart muscle may become damaged and unable to pump effectively. Heart failure, irregular heartbeat, and death may occur. In some cases, if the heart muscle has been severely and permanently damaged, a heart transplant may be considered. * corticosteroids (kor-tih-ko-STIR-oyds) are chemical substances made by the adrenal glands that have several functions in the body, including maintaining blood pressure during stress and controlling inflammation.

They can also be given to people as medication to treat certain illnesses. * diuretics (dye-yoor-EH-tiks) are medications that increase the body's output of urine. See also Pericarditis Overview, Causes - Pericarditis - HealthCommunities.com Pericarditis Overview, Causes Print Overview of Pericarditis The pericardium is a thin layer of specialized tissue that covers the outer surfaces of the heart. This tissue helps to anchor the heart in place, prevents excessive movement of the heart in the chest when body position changes, protects the heart from infections and tumors that develop in and may spread from nearby tissues, and may help keep the heart from enlarging. Inflammation of the pericardium is called pericarditis. Pericarditis frequently causes a characteristic chest pain that usually compels one to seek medical attention. Pericarditis Causes There are many causes of pericarditis, including infection, kidney failure, metastatic disease, some medications, and radiation therapy. Recent viral infection often precedes pericarditis in young, otherwise healthy patients. In idiopathic pericarditis, no clear cause is determined.

Patients who have suffered a heart attack (myocardial infarction) may develop pericarditis over subsequent days or weeks. Kidney failure caused by the buildup of certain toxins in the body also can lead to pericarditis. Cells from tumors in other parts of the body occasionally spread (metastasize) to the pericardium, leading to irritation and inflammation. Radiation therapy (used to treat cancer) can cause pericarditis also. Pericarditis can develop in patients with diseases in which the immune system becomes pathologically overactive, such as rheumatoid arthritis and lupus. Tuberculosis was a relatively common cause of pericarditis in the past, but this is now rare. Some medications can trigger an immune response that causes pericarditis. These medications include the antituberculosis medicine isoniazid (Nydrazid), the hypertension (high blood pressure) and heart failure medicine hydralazine (Apresoline), the antibiotic penicillin, the antiarrhythmic agent procainamide (Procanbid, Pronestyl), and the seizure medication phenytoin (Dilantin). Publication Review By: Stanley J.

Swierzewski, III, M.D. Published: 01 Jul 2000 Pericarditis | definition of pericarditis by Medical dictionary Pericarditis | definition of pericarditis by Medical dictionary Definition Pericarditis is an inflammation of the two layers of the thin, sac-like membrane that surrounds the heart. This membrane is called the pericardium, so the term pericarditis means inflammation of the pericardium. Description Pericarditis is fairly common. It affects approximately one in 1,000 people. The most common form is caused by infection with a virus. People in their 20s and 30s who have had a recent upper respiratory infection are most likely to be affected, along with men aged 20-50. One out of every four people who have had pericarditis will get it again, but after two years these relapses are less likely. Causes and symptoms The viruses that cause pericarditis include those that cause influenza , polio, and rubella (German measles ).

In children, the most common viruses that cause pericarditis are the adenovirus and the cocksackievirus (which is most likely to affect children during warmer weather). Although pericarditis is usually caused by a virus, it also can be caused by an injury to the heart or it can follow a heart attack . It may also be caused by certain inflammatory diseases such as rheumatoid arthritis or systemic lupus erythematosus. Bacteria, fungi, parasites, tuberculosis , cancer or kidney failure may also affect the pericardium. Sometimes the cause is unknown. There are several forms of pericarditis, depending on the cause. Acute pericarditis This is caused by infection with a virus, bacteria, or fungus—usually in the lungs and upper respiratory tract. This form of the disease causes a sharp, severe pain that starts in the region of the breastbone. If the pericarditis is caused by a bacteria, it is called bacterial or purulent pericarditis. Cardiac tamponade Sometimes fluid collects between the heart and the pericardium. This is called pericardial effusion, and may lead to a condition called cardiac tamponade.

When the fluid accumulates, it can squeeze the heart and prevent it from filling with blood. This keeps the rest of the body from getting the necessary supply of oxygen and can cause dangerously low blood pressure. A cardiac tamponade can happen when the chest is injured during surgery, radiation therapy, or an accident. Cardiac tamponade is a serious medical emergency and must be treated immediately. Constrictive pericarditis When the pericardium is scarred or thickened, the heart has difficulty contracting. This is because the pericardium has shrunken or tightened around the heart, constricting the muscle's heart movement. This usually occurs as a result of tuberculosis, which now is rarely found in the United States, except in immigrant, AIDS , and prison populations.

Symptoms of pericarditis Symptoms likely to be associated with pericarditis include: rapid breathing fever and chills weakness broken blood vessels (hemorrhages) in the mucus membrane of the eyes, the back, the chest, fingers, and toes feelings of anxiety A sharp or dull pain that starts in the front of the chest under the breastbone and radiates to the left side of the neck, upper abdomen, and left shoulder the pain is less intense when the patient sits up or leans forward and worsens when lying down; it may worsen with a deep breath, like pleurisy, which may accompany pericarditis In cardiac tamponade, neck veins may be swollen and blood pressure may be very low. Diagnosis The heart of a person with pericarditis is likely to produce a grating sound (friction rub) when heard through a stethoscope. This sound occurs because the roughened pericardium surfaces are rubbing against each other. The following tests will also help diagnose pericarditis and what is causing it: electrocardiograph (ECG) and echocardiogram to distinguish between pericarditis and a heart attack.

x ray to show the traditional "water bottle" shadow around the heart that is often seen in pericarditis where there is a sufficient fluid build up. computed tomography scan (CT scan) of the chest. heart catheterization to view the heart's chambers and valves. pericardiocentesis to test for viruses, bacteria, fungus, cancer, and tuberculosis. blood tests such as LDH and CPK to measure cardiac enzymes and distinguish between a heart attack and pericarditis, as well as a complete blood count (CBC) to look for infection. Treatment Since most pericarditis is caused by a virus and will heal naturally, there is no specific, curative treatment. Ordinary antibiotics do not work against viruses. Pericarditis that comes from a virus usually clears up in two weeks to three months. Medications may be used to reduce inflammation, however. They include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin. Corticosteroids are helpful if the pericarditis was caused by a heart attack or systemic lupus erythematosus. Analgesics (painkillers such as aspirin or acetaminophen ) also may be given.

If the pericarditis recurs, removal of all or part of the pericardium (pericardiectomy) may be necessary. In the case of constrictive pericarditis, the pericardiectomy may be necessary to remove the stiffened Cardiac tamponade occurs when fluid collects in the pericardial sac between the heart and the surrounding pericardium. A medical emergency, cardiac tamponade deprives the body of oxygen and requires immediate treatment. (Illustration by Electronic Illustrators Group.) parts of the pericardium that are preventing the heart from beating correctly. If a cardiac tamponade is present, it may be necessary to drain excess fluid from the pericardium. Pericardiocentesis, the same procedure used for testing, will be used to withdraw the fluid. For most people, home care with rest and medications to relieve pain are sufficient. A warm heating pad or compress also may help relieve pain. Sitting in an upright position and bending forward helps relieve discomfort. A person with pericarditis may also be kept in bed, with the head of the bed elevated to reduce the heart's need to work hard as it pumps blood.

Along with painkillers and antibiotics, diuretic drugs ("water pills") to reduce fluids may also be used judiciously. Prognosis Prognosis is good. Most people recover within three weeks to several months and do not need any additional treatment. Key terms Computed tomography (CT) scan — A CT scan uses x rays to scan the body from many angles. A computer compiles the x rays into a picture of the area being studied. The images are viewed on a monitor and printed-out. Echocardiogram — An echocardiogram bounces sound waves off the heart to create a picture of its chambers and valves. Electrocardiogram (ECG) — An ECG is a test to measure electrical activity in the heart. Heart catheterization — A heart catheterization is used to view the heart's chamber and valves. A tube (catheter) is inserted into an artery, usually in the groin. A dye is then put into the artery through the tube. The dye makes its way to the heart to create an image of the heart on x-ray film. The image is photographed and stored for further examination.

Pericardiocentesis — Pericardiocentesis is a procedure used to test for viruses, bacteria, and fungus. The physician puts a small tube through the skin, directly into the pericardial sac, and withdraws fluid. The fluid then is tested for viruses, bacteria, and fungus. Pericardium — The pericardium is the thin, sac-like membrane that surrounds the heart. It has two layers: the serous pericardium and the fibrous pericardium. Prevention There is no way to prevent pericarditis, but a healthy lifestyle with proper nutrition and exercise will help keep the body's immune system strong and more likely to fight off invading microorganisms. Resources Organizations American Heart Association. 7320 Greenville Ave. Dallas, TX 75231. (214) 373-6300 or (800) 242-8721. inquire@heart.org. National Heart, Lung and Blood Institute. P.O. Box 30105, Bethesda, MD 20824-0105. (301) 251-1222.

pericarditis Inflammation of the pericardium. pericarditis (per´ikärdī´tis), n an inflammation of the pericardium associated with trauma, malignant neoplastic disease, infection, uremia, myocardial infarction, collagen disease, or idiopathic causes. pericarditis inflammation of the pericardium. Initially there is an audible friction rub on auscultation. Later as fluid accumulates there is a muffling of the heart sounds and sometimes a washing machine sound on auscultation. Congestive heart failure develops terminally. Classified according to exudate produced as fibrinous, fibrinohemorrhagic, hemorrhagic, purulent. bread-and-butter pericarditis see bread and butter pericarditis . constrictive pericarditis adhesions between the epicardium and pericardium limit the movement of the heart sometimes sufficiently to cause congestive heart failure. niche pericarditis see niche pericarditis. traumatic pericarditis occurs in cattle and goats, rarely sheep, when a sharp foreign body is swallowed and lodges in the reticulum, subsequently perforating its wall.

The perforation may go as far forward as the pericardial sac, especially if the animal is pregnant. The animal dies of a combination of congestive heart failure and toxemia due to the bacterial infection. Pericarditis | Health | Patient Pericarditis 1041 Pericarditis is inflammation of the pericardium - the sac which surrounds the heart. Pericarditis causes chest pains. Most cases are due to a viral infection which usually goes away within a few weeks. The only treatment usually needed for a 'viral pericarditis' is anti-inflammatory medication. There are some less common causes of pericarditis which may need other treatments. Complications are uncommon but can be serious. What are the pericardium and pericarditis? The pericardium is a thin sac-like tissue that covers the outer surface of the heart. It helps to anchor the heart in place and prevents the heart from moving in the chest when you move. The pericardium has an inner and outer layer. There is a thin layer of 'lubricating' fluid between the two layers. Pericarditis means inflammation of the pericardium.

What are the causes of pericarditis? Viral infection Infection with a virus is the most common cause. Several different viruses can cause pericarditis, including Coxsackieviruses, echoviruses, influenza viruses, adenoviruses, the mumps virus, human immunodeficiency virus (HIV) and viruses that cause hepatitis. Other causes Other causes are uncommon and include: Infection with a germ (bacterium). This often causes pus to form between the inner and outer layers of the pericardium. The infection has usually spread from nearby tissues (such as an infection of the heart itself) or from a wound infection following heart surgery. Rarely, syphilis or fungi can infect the pericardium. Tuberculosis (TB) infection. This is usually as part of a more widespread TB infection in the lungs and other parts of the body. Uraemic pericarditis. This is inflammation caused by waste products building up in the bloodstream in people with untreated kidney failure. Heart attack (myocardial infarction). Inflammation of the pericardium may occur if there is damage to nearby heart tissue, caused by a heart attack. Following heart surgery.

Inflammation can occur a few days to a few weeks after open heart surgery. Following injury - for example, following a stab wound, or a severe blow to the chest. Inflammatory diseases which can affect various parts of the body may include inflammation of the pericardium - for example, rheumatoid arthritis, scleroderma, polyarteritis nodosa and systemic lupus erythematosus (SLE). Radiotherapy to treat cancers in the chest. Cancer which has spread to the pericardium from another part of the body (this is very rare). Idiopathic pericarditis In many cases, no cause can be found. This is called idiopathic pericarditis. Many of these cases are probably caused by a viral infection which is not able to be identified. What are the symptoms of pericarditis? Symptoms of viral and idiopathic pericarditis The typical symptoms are chest pain and high temperature (fever). The pain is usually in the middle of the chest or slightly left of centre. It may feel sharp and stabbing. Sometimes it is a persistent steady pain. The pain may spread to the neck and/or shoulders.

Typically, the pain gets worse if you take a deep breath, swallow, cough, or lie down. The pain may ease if you sit up or lean forward. You may also feel breathless, especially if tamponade develops (see below). Symptoms of other causes of pericarditis These may be similar to viral pericarditis. Depending on the underlying cause of the pericarditis, there may also be various other symptoms. What are the possible complications of pericarditis? Complications are uncommon. They include the following: Build-up of fluid In many cases of pericarditis a small amount of fluid builds up between the two layers of the pericardium. This is called a pericardial effusion. A small amount of fluid is no problem and usually goes when the inflammation settles. However, sometimes a lot of fluid builds up and can press on the heart. This can prevent the heart chambers from filling normally and prevents the heart from pumping blood properly. This is called cardiac tamponade and is a life-threatening problem unless the fluid is quickly drained. Severe breathlessness can develop quickly within minutes or hours. If this happens, you should see a doctor urgently.

Constrictive pericarditis This is an uncommon condition that may develop if the pericardium has been inflamed for a long time. The pericardium thickens and contracts around the heart. This is serious, as it can interfere with the function of the heart. With both of the above complications, symptoms include shortness of breath which becomes worse and worse. Other symptoms of constrictive pericarditis may include swollen legs and ankles and tiredness. How is pericarditis diagnosed? When a doctor listens to your chest with a stethoscope, he or she may hear a typical sound which occurs with pericarditis. It is called a pericardial friction rub. It sounds like a grating noise. This does not occur in all cases. Other conditions can cause similar symptoms to pericarditis. Therefore, tests may be needed to clarify the diagnosis and to rule out other causes of chest pain: A chest X-ray may show a change in the shape of the heart (a flask-shaped heart) or fluid in the lung cavity. An electrocardiogram (ECG) . This is a tracing of the electrical activity of the heart. It sometimes shows typical patterns if you have pericarditis.

An echocardiogram . This is an ultrasound scan of the heart. It shows the structure of the heart and surrounding tissues. It can detect if any fluid has built up between the layers of pericardium, which is typical of pericarditis. Other tests such as a magnetic resonance imaging (MRI) scan or computerised tomography (CT) scan may be needed to look for changes in the pericardium. These tests tend to be done if a cause other than a viral infection is suspected. If a large pericardial effusion develops, a sample of the fluid may be taken with a needle and syringe and analysed for infections such as TB. What is the treatment for pericarditis? Treatment for viral or idiopathic pericarditis Anti-inflammatory medicines such as ibuprofen are usually given to ease the pain and reduce inflammation. If the condition carries on for more than 14 days you may also be given a medicine called colchicine, which helps to improve the outcome and reduce the chances of the inflammation coming back. If the pain is severe and you are not getting better with ibuprofen and colchicine, steroid medicines may be used to reduce the inflammation.

The pain and inflammation usually settle within a few weeks. More related content Treatment for other causes and for complications The treatment depends on the cause. For example, antituberculosis medication for TB, antibiotic medicines for germ (bacterial) infections, intensive dialysis for uraemic pericarditis, etc. If a lot of fluid builds up and causes cardiac tamponade, the fluid needs to be drained with a needle and syringe. If constrictive pericarditis develops and interferes with the heart's function, the thickened pericardium may need to be removed by an operation. This is called a pericardiectomy. What is the outlook (prognosis) if you have pericarditis? Most people with viral or idiopathic pericarditis recover fully within a few weeks, without any complications. However, in some cases the symptoms return 'on and off' for several months. Pericarditis caused by heart attack or injury usually settles over one to two weeks. The outlook for other forms of pericarditis (uraemic, bacterial, TB, etc - see above) can vary depending on the severity of the underlying cause.

Further help & information References & Disclaimer | Provide Feedback Further reading & references Pericarditis Causes - Mayo Clinic By Mayo Clinic Staff Under normal circumstances, the two-layered pericardial sac that surrounds your heart contains a small amount of lubricating fluid. In pericarditis, the sac becomes inflamed and the resulting friction from the inflamed sac leads to chest pain. The cause of pericarditis is often hard to determine. In most cases, doctors either are unable to determine a cause (idiopathic) or suspect a viral infection. Pericarditis can also develop shortly after a major heart attack, due to the irritation of the underlying damaged heart muscle. In addition, a delayed form of pericarditis may occur weeks after a heart attack or heart surgery. This delayed pericarditis is known as Dressler's syndrome. Many experts believe Dressler's syndrome is due to a mistaken inflammatory response by the body to its own tissues (autoimmune response) — in this case, the heart and pericardium. Other causes of pericarditis include: Systemic inflammatory disorders. These may include lupus and rheumatoid arthritis. Trauma.

Injury to your heart or chest may occur as a result of a motor vehicle or other accident. Other health disorders. These may include kidney failure, AIDS, tuberculosis and cancer. Certain medications. Some medications can cause pericarditis, although this is unusual. Shammas NW, et al. Pericarditis, myocarditis, and other cardiomyopathies. Primary Care: Clinics in Office Practice. 2013;40:213. What is pericarditis? National Heart, Lung, and Blood Institute. Accessed Dec. 19, 2013. What is pericarditis? American Heart Association. #. Accessed Dec. 19, 2013. Imazio M. Clinical presentation and diagnostic evaluation of acute pericarditis. Accessed Dec. 19, 2013. Acute coronary syndromes. The Merck Manuals: The Merck Manual for Health Care Professionals. Accessed Dec. 19, 2013. Crawford MH, ed. Current Diagnosis & Treatment: Cardiology. 3rd ed. New York, N.Y.; The McGraw Hill Companies: 2009. Accessed Dec.

19, 2013. Imazio M. Treatment of acute pericarditis. Accessed Dec. 19, 2013. Lilly LS. Treatment of acute and recurrent idiopathic pericarditis. Circulation. 2013;127:1723. Imazio M, et al. A randomized trial of colchicines for acute pericarditis. New England Journal of Medicine. 2013;369:1522. Khandaker MH, et al. Pericardial disease: Diagnosis and management. Mayo Clinic Proceedings. 2010;85:572. Products and Services Pericarditis: MedlinePlus Medical Encyclopedia Treatment The cause of pericarditis should be identified, if possible. High doses of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are often given with a medicine called colchicine. These medicines will decrease your pain and reduce the swelling or inflammation in the sac around your heart.

If the cause of pericarditis is an infection: Antibiotics will be used for bacterial infections Antifungal medicines will be used for fungal pericarditis Other medicines that may be used are: Corticosteroids such as prednisone (in some people) "Water pills" (diuretics) to remove excess fluid If the buildup of fluid makes the heart function poorly, treatment may include: Draining the fluid from the sac. This procedure, called pericardiocentesis, may be done using an echocardiography-guided needle. Cutting a small hole (window) in the pericardium (subxiphoid pericardiotomy) to allow the infected fluid to drain into the abdominal cavity Surgery called pericardiectomy may be needed if the pericarditis is long-lasting, comes back after treatment, or causes scarring or tightening of the tissue around the heart. The operation involves cutting or removing part of the pericardium. Outlook (Prognosis) Pericarditis can range from mild illness that gets better on its own, to a life-threatening condition. Fluid buildup around the heart and poor heart function can complicate the disorder.

The outcome is good if pericarditis is treated right away. Most people recover in 2 weeks to 3 months. However, pericarditis may come back. This is called recurrent, or chronic, if symptoms or episodes continue. Scarring and thickening of the sac-like covering and the heart muscle may occur when the problem is severe. This is called constrictive pericarditis . It can cause long-term problems similar to those of heart failure. When to Contact a Medical Professional Call your provider if you have symptoms of pericarditis. This disorder is not life threatening most of the time. However, it can be very dangerous if not treated. Prevention Many cases cannot be prevented. Images Pericarditis References Imazio M, Gaita F, LeWinter M. Evaluation and treatment of pericarditis: A systematic review. JAMA. 2015; 314(14):1498-1506. PMID: 26461998 . LeWinter MM, Hopkins WE. Pericardial diseases. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds.

Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 71. Read More Pericarditis - National Library of Medicine - PubMed Health Systematic review of randomised controlled trials about the efficacy and safety of colchicine in people with pericarditis Pericarditis is the inflammation and swelling of the tissue covering the outer layer of the heart. Pericarditis causes severe and disabling chest pain and fever, however the main issue is the repeated recurrence of pericarditis attacks. Colchicine is an ancient medication that has been used in the treatment of other inflammatory diseases such as gout. Tuberculosis infection of the membrane around the heart is uncommon but life threatening. There is little reliable research on best practice in relation to what drugs to give and when and how to operate. Currently doctors prescribe antituberculous drugs and remove the membrane if it is making the patient ill. However, doctors vary in the way they manage this condition in terms of what antituberculous drugs to give and when to operate. We found no clinical trials that tackled the length of anti‐TB treatment needed.

Trials of steroids given with antituberculous drugs suggest possible benefit, but this was not demonstrated conclusively. Open surgical drainage of the fluid accumulating between the heart and the membrane using general anaesthesia was associated with less life threatening re‐accumulation of fluid (cardiac tamponade), but with more deaths, but conclusions are not possible as the numbers of patients studied was too small. Colchicine for the prevention of pericarditis: what we know and what we do not know in 2014 – systematic review and meta-analysis AIMS: The purpose of this study was to investigate and summarize available evidence on the efficacy and safety of colchicine for pericarditis prevention. Disease recurrence is the major and most common complication of pericarditis and its prevention may reduce morbidity and management costs. Colchicine has been intensively studied in the last decade for pericarditis prevention. Systematic review of randomised controlled trials about the efficacy and safety of colchicine in people with pericarditis Pericarditis is the inflammation and swelling of the tissue covering the outer layer of the heart.

Pericarditis causes severe and disabling chest pain and fever, however the main issue is the repeated recurrence of pericarditis attacks. Colchicine is an ancient medication that has been used in the treatment of other inflammatory diseases such as gout. Tuberculosis infection of the membrane around the heart is uncommon but life threatening. There is little reliable research on best practice in relation to what drugs to give and when and how to operate. Currently doctors prescribe antituberculous drugs and remove the membrane if it is making the patient ill. However, doctors vary in the way they manage this condition in terms of what antituberculous drugs to give and when to operate. We found no clinical trials that tackled the length of anti‐TB treatment needed. Trials of steroids given with antituberculous drugs suggest possible benefit, but this was not demonstrated conclusively. Open surgical drainage of the fluid accumulating between the heart and the membrane using general anaesthesia was associated with less life threatening re‐accumulation of fluid (cardiac tamponade), but with more deaths, but conclusions are not possible as the numbers of patients studied was too small. Adjunctive steroid therapy for managing pulmonary tuberculosis Pulmonary tuberculosis is a common infectious disease.

Although curable with standard anti‐pulmonary tuberculosis drugs, it has been reported that an individuals recovery could be improved by adding corticosteroids to their treatment. Current clinical guidelines advise the use of corticosteroids for treatment of other types of tuberculosis; tuberculosis meningitis and tuberculosis pericarditis. Whether corticosteroids would be beneficial in the treatment of pulmonary tuberculosis remains unclear. After reviewing the evidence available to date we found that there was not enough high quality data to support or reject corticosteroid use alongside anti‐pulmonary tuberculosis drugs. Endocarditis, Infectious - body, contagious, causes, What Is Endocarditis? Endocarditis, Infectious Endocarditis, Infectious Infectious endocarditis (in-FEK-shus en-do-kar-DYE-tis) is an inflammation of the valves and internal lining of the chambers of the heart, known as the endocardium (en-doh-KAR-dee-um), caused by an infection. KEYWORDS for searching the Internet and other reference sources Bacteremia Heart valve What Is Endocarditis? The heart has four chambers and four valves that regulate the flow of blood through the heart.

Each valve is made up of two or three smaller parts, known as leaflets, that swing open and shut. As the heart beats, it pumps blood through the chambers and out of the heart to the lungs and the rest of the body. The valves open to allow blood to pass through and out of the heart and then close to keep the blood from flowing backward. In a normal heart, the swift, smooth movement of blood sweeps foreign material such as bacteria away from the heart. However, some people have defects in the heart's valves, the endocardium, or other parts of the heart's structure that disrupt the flow of blood. This disruption can allow bacteria or other germs that reach the heart through the bloodstream to lodge there and multiply, which results in an infection that inflames the heart's valves, muscles, and endocardium, producing endocarditis. The inflammation (in-flah-MAY-shun), which is the body's response to injury or infection, can be serious, and sometimes it damages or destroys heart valves. What Causes Endocarditis? Viruses, fungi, or other microscopic organisms can all cause infectious endocarditis, but the disease usually arises from a bacterial infection.

A common bacterium that lives in the mouth, Streptococcus viridans (strep-tuh-KAH-kus VEER-ih-danz), is responsible for up to half of all cases of bacterial endocarditis. Other bacterial culprits include bacteria from the staphylococcus, streptococcus, and enterococcus families and, less commonly, other types. In most cases of endocarditis, bacteria that normally live harmlessly on the body, such as in the mouth, on the skin, in the intestines * , or in the urinary tract * (YOOR-ih-nair-e TRAKT), enter the blood (a condition known as bacteremia, bak-tuh-REE-me-uh). The bacteria can enter through a cut or a tear, frequently caused by a dental or medical procedure, or they may come from an infection somewhere else in the body. Once in the bloodstream, the bacteria travel to the heart and become stuck to the endocardium or heart valves. As they grow and multiply, the bacteria may form vegetations, which are composed of clumps of bacteria, red and white blood cells, and fibrin, a protein that helps blood clot * . Who Gets Endocarditis?

Endocarditis is not contagious, so there is no reason to avoid contact with someone who has it. The disease is not very common in people with normal hearts, but some people are more susceptible to it. Because bacteria can easily attach to a malformed part of the heart, people with an artificial or damaged heart valve or a heart defect are more likely to get endocarditis. Anyone who has had it before or who has a catheter * in a blood vessel also has a greater chance of becoming infected. Although many people with heart defects are born with them, other people develop defects during their lifetime, such as from intravenous * drug use or rheumatic fever * , which puts them at increased risk for endocarditis as well. Overall, between 1 and 4 cases per 100,000 people occur each year in the United States. What Are the Signs and Symptoms of Endocarditis? Flulike symptoms, such as fever and chills, are the most common symptoms of endocarditis. Some people experience weight loss, weakness, headache, tiredness, shortness of breath, joint and muscle pain, and excessive sweating at night (night sweats).

A heart murmur * usually develops, and the person may look pale, have red spots on their skin, and see blood in their urine. An enlarged spleen * , small hemorrhages * on the nails and on the whites of the eyes, and swelling of the feet, legs, and abdomen also can occur with endocarditis. * intestines are the muscular tubes that food passes through during digestion after it exits the stomach. * urinary tract is the system of organs and channels that makes urine and removes it from the body. It consists of the urethra. bladder, ureters, and kidneys. * clot is the process by which the body forms a thickened mass of blood cells and protein to stop bleeding. * catheter (KAH-thuh-ter) is a small plastic tube placed through a body opening into an organ (such as the bladder) or through the skin directly into a blood vessel. It is used to give fluids to or drain fluids from a person. * intravenous (in-tra-VEE-nus) means within or through a vein. For example, medications, fluid, or other substances can be given through a needle or soft tube inserted through the skin's surface directly into a vein.

* rheumatic (roo-MAH-tik) fever is a condition associated with fever, joint pain, and inflammation affecting many parts of the body, including the heart. It occurs following infection with certain types of strep bacteria. * heart murmur is an abnormal sound from the heart, heard with a stethoscope, that is usually related to the flow of blood through the heart. Some murmurs indicate a problem with a heart valve or other part of the heart's structures, but many murmurs do not indicate any problem. * spleen is an organ in the upper left part of the abdomen that stores and filters blood. As part of the immune system, the spleen also plays a role in fighting infection. How Do Doctors Diagnose and Treat Endocarditis? Doctors may suspect endocarditis if someone with a known heart abnormality develops an unexplained long-lasting fever, an abnormal heart sound (a murmur), or symptoms of heart failure such as shortness of breath or swelling of the legs. Certain tests can help doctors diagnose endocarditis, including blood cultures to detect bacteria in the bloodstream, a complete blood count, and laboratory tests that look for inflammation.

For example, checking a patient's erythrocyte sedimentation rate (ESR) shows how quickly the person's red blood cells, or erythrocytes (eh-RITH-ruh-sites), settle to the bottom of a test tube, which is a measure of inflammation in the body. Another blood test identifies levels of C-reactive protein, which is increased in the blood when there is significant inflammation in the body. Doctors may also use an echocardiogram to look for signs of infection on the heart valves or in the heart. An echocardiogram (eh-ko-KAR-dee-uh-gram) is a diagnostic test that uses sound waves to produce images of the heart's chambers and valves and observe blood flow through the heart. Doctors treat infectious endocarditis with antibiotics. The medication is given intravenously in the hospital at first, but sometimes patients finish treatment at home. Several weeks of antibiotic treatment may be necessary to eliminate the infection. In more serious cases, patients may need oxygen and medications to support heart function while hospitalized, and some people require surgery to repair damage to the heart caused by inflammation. Do People Recover from Endocarditis? The infection can start suddenly or come on gradually over weeks to months.

Left untreated, endocarditis is often fatal. However, when treated successfully with antibiotics and when there has been little damage done to the heart valves, patients usually begin to feel better within a few days. If the infection does not improve with antibiotics, or if there is evidence that the heart valves have been damaged significantly, surgery may be required to replace the valve to clear the infection from the body and restore heart function. Endocarditis can cause other complications. In some people with the disease, pieces of the infected material (vegetations) in the heart may break off and travel through the blood to other organs. If these pieces travel to the brain and block a blood vessel there, for example, the person may develop a stroke * . If they reach other organs, they may cause serious infections there. Endocarditis can also cause an irregular heartbeat, jaundice * , and kidney failure, as well as heart failure. * hemorrhages (HEH-muh-rih-jes) are areas of uncontrolled or abnormal bleeding. * stroke is a brain-damaging event usually caused by interference with blood flow to the brain. A stroke may occur when a blood vessel supplying the brain becomes clogged or bursts, depriving brain tissue of oxygen.

As a result, nerve cells in the affected area of the brain, and the specific body parts they control, do not properly function. * jaundice (JON-dis) is a yellowing of the skin, and sometimes the whites of the eyes, caused by a buildup in the body of bilirubin, a chemical produced in and released by the liver. An increase in bilirubin may indicate disease of the liver or certain blood disorders, * respiratory tract includes the nose, mouth, throat, and lungs. It is the pathway through which air and gases are transported down into the lungs and back out of the body. * urethra (yoo-REE-thra) is the tube through which urine passes from the bladder to the outside of the body, * gastrointestinal (gas-tro-in-TES-tih-nuhl) means having to do with the organs of the digestive system, the system that processes food. It includes the mouth, esophagus, stomach, intestines, colon, and rectum and other organs involved in digestion, including the liver and pancreas. How Is Endocarditis Prevented?

Doctors give antibiotics to people who are at risk for infectious endocarditis before they undergo procedures that could introduce bacteria into the bloodstream. For example, simple dental work, removal of the tonsils, or medical procedures involving parts of the upper respiratory tract * (such as the mouth and throat), urinary tract (such as the urethra * ), or lower gastrointestinal * tract can all provide an avenue for bacteria to enter the bloodstream and travel to the heart. See also

Question: In humans, pericarditis affects which part of the body?
Answer: Heart