Pericarditis Treatment A Guide to its Causes, Symptoms, and Management in Indian Patients

Viral/bacterial/fungal infections – The most common cause of pericarditis is a viral or bacterial infection. A person may get an infection of the pericardium layer from a respiratory infection, urinary tract or kidney infection. Also, if a person has an infection of the throat or sinuses, he/she may swallow bacteria that can infect the pericardium.

Respiratory infections – Respiratory infections caused by a virus may lead to viral pericarditis symptoms in some individuals. Respiratory infections are more common among adults and the elderly but respiratory infections can affect people of all ages. People who smoke are more likely to get respiratory infections than people who do not.

Autoimmune conditions like lupus, scleroderma and rheumatoid arthritis – These autoimmune diseases can affect the immune system, which is the body’s defence against foreign invaders like bacteria and viruses. When the immune system cannot tell between harmful “foreign” substances and healthy ones, it attacks both types indiscriminately which can lead to signs of heart inflammation or swelling in various parts of the body.

Digestive system infections – Pericarditis can develop after a gastrointestinal infection. In most cases, viral pericarditis develops as a complication to appendicitis or diverticulitis. In this case, the infection spreads from the appendix or intestine to the pericardium of the heart, leading to inflammation.

Heart surgeries – People who have undergone heart surgery are at a higher risk of developing pericarditis. If the patient is experiencing severe pain in the chest, it may be due to inflammation or swelling of the pericardium after undergoing procedures, such as coronary bypass grafting and valve replacement surgeries.

Kidney failures – People with kidney diseases are also at high risk of developing pericarditis. The kidneys help remove waste products from the body, so if they become damaged or diseased, it can lead to pericardium fluid accumulation in the chest cavity leading to pericardial effusion and eventually signs of heart inflammation.

HIV – People who are HIV positive may develop viral pericarditis. The reason is that when the immune system starts to fail in people with AIDS, it cannot fight against infections anymore and this makes them vulnerable to many different types of diseases, including bacteria or viral infections.

Cancer – Cancer-causing infections in the chest can also cause pericarditis. In this case, cancer cells migrate to the surface of the pericardium layers and lead to inflammation or swelling of the pericardium of the heart. This can lead to severe chest pain and difficulty in breathing.

Injuries from accidents/radiation therapy – People who have undergone radiation therapy of the chest area where the heart is located may develop pericarditis. In some cases, injuries from accidents or trauma to the chest can lead to inflammation and swelling of the sac around the heart. 

Certain medications – Few medications that people take for treating certain conditions may lead to viral pericarditis. For example, a person who is taking blood-thinning medication (anticoagulants), such as warfarin or heparin, is at risk of developing swelling in the pericardium.

Chest pain – Acute left side chest pain can be a symptom of pericarditis in Indian patients. The chest pain associated with pericarditis may feel similar to that of a heart attack, but there are some differences between them that make it easier for doctors to distinguish one from another. Heart attack symptoms last longer and also include other signs like shortness of breath or feeling nauseated while pericardial chest pain lasts only for a few hours each time, along with general body weakness. 

The intensity and the location of the chest pain may vary depending on what pericarditis is caused by. Sometimes, it may feel like a sharp stabbing sensation in between the shoulder blades (left side) and under the breastbone (centre). The pain may also spread to other areas like the neck, arms, back or jaw. In some cases, patients feel their skin over the centre of their chests become unusually tight. Chest pain causes and treatment should be taken care of as early as possible.

Swelling in the legs or abdomen – Swelling in the legs or abdomen is also a sign of pericarditis. This symptom occurs due to the accumulation of pericardium fluid around the heart and it can indicate that there is an underlying cause for inflammation, such as cancer or kidney disease.

Abnormal cough – The pericarditis patient may also experience an abnormal cough. This symptom is often associated with heart-related problems, so individuals who are experiencing this should talk to their doctor to get more clarity on their diagnosis.

Palpitations – An individual may feel their heartbeat more than usual or it could become irregular, particularly when they are resting. This symptom is known as “palpitation”.

Shortness of breath when lying down – Shortness of breath, especially when lying down flat, happens because the pericardial fluid accumulates in parts surrounding the lungs, making breathing difficult for patients with pericarditis.

Fatigue and weakness – Individuals suffering from acute pericarditis symptoms; tend to feel weak and fatigued easily due to low levels of energy production.

Low-grade fever – People with pericarditis may also experience low-grade fever, making them feel chills and shivers. This symptom is not dangerous but it can make the patient feel uncomfortable.

Other symptoms – Other less common signs of pericarditis include nausea, vomiting, loss of appetite and weight loss (cachexia) and sweating at night (night sweats).

Chest X-ray – This allows doctors to see if the fluid is present in the pericardial sac. X-ray helps in identifying pericardial effusion and other signs of the condition.

Electrocardiogram (ECG/EKG) – This pericarditis test records the electrical activity in your heart to detect changes in your heartbeat that can occur if you have pericarditis pain. Simply put, ECG helps doctors understand how an individual’s heartbeats and its electrical activity over time by recording it on paper or digital screens.

Echocardiogram – This technique uses ultrasound waves to create an image of how much pericardium fluid is around or inside your heart. It is also helpful in understanding the risk of pericardial effusion and cardiac tamponade that may occur with the condition but it cannot confirm the presence of both conditions.  

Chest CT scan – This pericarditis test creates multiple X-ray images taken from different angles to enable doctors to visualize structures within an organ like the lungs or heart more clearly than previously possible with conventional imaging techniques. During this procedure, doctors inject contrast material into your vein so they can see blood vessels on computer screens better. This enables them to identify inflamed pericardium layer and haemorrhage (bleeding) among other things related to pericarditis pain.

MRI scan – Magnetic resonance imaging uses powerful magnets instead of X-rays to produce images that appear brighter than regular X-ray pictures produced using radiation technology. By looking at MRI images of the pericardium, doctors can determine if it is inflamed or not.

Blood tests – Doctors may also ask for a blood test to rule out infections and other conditions that might be associated with pericarditis pain.

Pericardiocentesis – This is a minor procedure where doctors use needles guided by viewing instruments to withdraw the pericardial fluid from the pericardial sac. Pericardiocentesis may also provide relief in some cases if you are experiencing cardiac tamponade due to an accumulation of fluid in the pericardium. The procedure requires a short stay in the hospital and it is usually considered safe. However, there are risks associated with this procedure, which may include pain or difficulty breathing after the surgery that may require additional treatment of pericarditis. The patient may be under anaesthesia during the procedure and once it is completed, they may be monitored for a period of time.

Pericardiectomy – This is a surgical procedure where doctors remove all or part of the pericardium. It may provide relief in some cases by removing the source of excess pressure on your heart and lungs. Pericardiectomy can also be done through minimally invasive surgery but it still requires you to spend time at the hospital and it carries a risk of complications like cardiac tamponade and bleeding. Moreover, the recovery time is longer when compared to pericardiocentesis. This procedure is usually not recommended if you have a mild pericardial effusion.

Bleeding or infection post-surgery

Cardiac tamponade occurs due to the accumulation of pericardial fluid around your heart that can result in difficulty breathing and chest pain.

Other rare complications include blood clots as well as nerve damage due to improper placement of a catheter during pericardiocentesis, which requires immediate medical attention. If left untreated, it could lead to paralysis over time.

Scheduling regular medical checkups and follow-ups with the doctor – If you have a family history of pericarditis or if your job requires you to be in contact with certain types of bacteria, chemicals or dangerous substances, make sure that you visit your doctor regularly. This will help them monitor any changes in the heart and identify early signs of infection before it spreads to other body parts. For instance, if you are exposed to pesticides or other harmful chemicals at work, make sure that you wear protective gear and always follow measures for safety when handling these products.

Upholding hygiene standards – Make sure that you maintain good hygiene levels and wash your hands often. This will help protect yourself from any bacteria or viruses, which could lead to an infection in the pericardium.

Avoiding stressful situations – If you suffer from chronic stress at work or home, make some changes for the better today. Regular exercise is a great way of keeping stress at bay. You can also try out yoga or meditation, as they are known to reduce the amount of cortisol in your body and improve blood circulation over time. Finally, make sure that you prioritize enough sleep (seven to eight hours per night) for a healthier lifestyle. Yoga, meditation and regular exercise are great ways to relax your mind and body from the daily stress of life.

Stay hydrated – Keep yourself well-hydrated by drinking plenty of water throughout the day. This will help keep you energized for all those household chores and errands. It will also prevent dryness in the pericardium, which is a common cause of infection and inflammation over time.

Eating healthy – What you eat also plays a big part in preventing pericarditis. Make sure that your diet contains plenty of heart-healthy foods like fruits and vegetables, whole grains, lean meats such as chicken and fish, nuts, low-fat dairy products like milk and yoghurt, beans and legumes (kidney beans), eggs, etc.

Lifestyle changes – Introduce a few changes in your lifestyle to lead a healthier life. For instance, if you smoke tobacco products like cigarettes and cigars, quit today and ask your doctor about safe alternatives such as nicotine gums and patches.