Pericarditis

The pericardium is the thin sac means membrane that covers the outer surfaces of the heart. This membrane 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. The pericardium has an inner and outer layer with a small amount of lubricating fluid between them. When the pericardium becomes inflamed, the amount of fluid between the two layers increases. Inflammation of the pericardium is known as pericarditis.

Causes

• Several factors that may be the causes of pericarditis including infection, kidney failure, and radiation therapy.
• Pericarditis may be associated with systemic diseases such as autoimmune disorders, rheumatic fever, tuberculosis, cancer, leukemia, HIV infections, AIDS and hypothyroidism.
• Pericarditis may also be occur due to side effect of some medications, isoniazid, cyclosporine.
• The viruses that may cause pericarditis include those that cause influenza, polio, and rubella (German measles). In children, the most common viruses that may cause pericarditis are the adenovirus and the cocksackievirus.

Symptoms

• Chest pain is the most common presenting symptom +++. The pain is usually pleuritic but sometimes is dull; it may radiate to the left trapezius, is aggravated by supine posture, and is often alleviated by sitting up. The pain may last hours or days and is usually constant, but may be intermittent.
• Dyspnea ++
• Fever
• Fatigue
• Malaise
• Abdominal pain
• Syncope

Signs

• Pericardial friction rub +++, classically of three components, is best heard over the left sternal border and is usually accentuated by sitting up and leaning forward. Only one or two components may be present, and it may be audible only intermittently or over a limited area. When only a single component is present, it can be confused with a murmur.

Treatment

• The primary treatment of this condition is the use of anti-inflammatory agents. Aspirin is effective and is sometimes used as initial therapy. Usually, one of a group of agents known as nonsteroidal anti-inflammatory drugs (NSAIDs) is prescribed such as ibuprofen (Advil®, Medipren®, Motrin®, Nuprin®, Rufen®), indomethacin (Indocin®). NSAIDs are usually quite effective in reducing inflammation and eliminating the pain associated with pericarditis.
• You can treat bacterial pericarditis with antibiotics. Fungal pericarditis can be treated with antifungal agents.