- Pain relievers. Pericarditis pain can usually be treated with over-the-counter pain relievers, such as aspirin or ibuprofen (Advil, Motrin IB, others). ...
- Colchicine (Colcrys, Mitigare). This drug reduces inflammation in the body. ...
- Corticosteroids. Corticosteroids are strong medications that fight inflammation.
Medication
The treatment of Drug-Induced Pericarditis may include the following measures:
- Discontinuing the medication responsible for the side effect may result in a cure, or in improvement of the condition
- The use of medications to manage pain such as: Analgesics (to relieve pain) Anti-inflammatory medication (to decrease inflammation)
- Plenty of rest (bed rest) will be recommended as well
Procedures
- Preventing your heart from over-increases
- Protecting your heart from infections and damage
- Keeping your heart lubricated.
Which medications may be used to treat pericarditis?
Part 1 Part 1 of 2: Easing Pericarditis with Home Care
- Recognize the symptoms of a pericarditis attack. Most pericarditis attacks come on quickly and do not usually last long.
- Get sufficient rest. Most mild cases of pericarditis go away with rest. ...
- Take an over-the-counter (OTC) pain reliever. ...
- Switch your position. ...
- Minimize your risk of pericarditis. ...
How to treat pericarditis naturally?
- Acute pericarditis begins suddenly but doesn't last longer than three weeks. ...
- Recurrent pericarditis occurs about four to six weeks after an episode of acute pericarditis with no symptoms in between.
- Incessant pericarditis lasts about four to six weeks but less than three months. ...
How to get rid of pericarditis?
What is the difference between acute and chronic pericarditis?
What is the most common treatment for pericarditis caused by a viral infection?
Types of treatment If your pericarditis is caused by a viral infection, you may be told to take over-the-counter, anti-inflammatory medicines to reduce pain and inflammation. Examples of these medicines are aspirin and ibuprofen. Stronger medicine may be needed if the pain is severe.
Can pericarditis be cured without surgery?
In most cases , pericarditis is mild and will clear up on its own with simple treatment, like anti-inflammatory medications and rest. If you have other medical risks, your doctor may initially treat you in the hospital. Treatment aims to reduce your pain and inflammation and minimize the risk of recurrence.
What is the prognosis for pericarditis?
Long-term survival after pericardiectomy depends on the underlying cause. Of common causes, idiopathic constrictive pericarditis has the best prognosis (88% survival at 7 years), followed by constriction due to cardiac surgery (66% at 7 years).
How do you get rid of chronic pericarditis?
The only possible cure for chronic constrictive pericarditis is surgical removal of the pericardium. Surgery cures about 85% of people.
What causes pericarditis flare ups?
Causes of pericarditis The cause of pericarditis is often unknown, though viral infections are a common reason. Pericarditis may occur after a respiratory or digestive system infection. Chronic and recurring pericarditis may be caused by autoimmune disorders such as lupus, scleroderma and rheumatoid arthritis.
How fast does colchicine work for pericarditis?
Addition of colchicine to standard therapy results in earlier reduction in pericarditis symptoms, greater remission at 1 week, and reduces the rate of recurrent pericarditis.
Can you live a long life after pericarditis?
What is the survival rate of pericarditis? Without treatment, the survival rate of constrictive pericarditis is low. After a pericardiectomy, 78% of people can live five years and 57% live another 10 years.
Can you live a normal life with pericarditis?
Living With Pericarditis Many cases of pericarditis are mild and go away on their own. But other cases, if not treated, can lead to chronic pericarditis and serious problems that affect your heart. Some problems can be life threatening. Sometimes it takes weeks or months to recover from pericarditis.
What are the chances of dying from pericarditis?
Death in patients hospitalized for acute pericarditis is uncommon (1%), and mortality is most often not related to pericarditis (6); 1% to 2% of patients will have pericardial tamponade during the first acute attack.
Can pericarditis be permanent?
Some people with long-term pericarditis develop permanent thickening and scarring of the pericardium. The changes prevent the heart from filling and emptying properly. This unusual complication often leads to severe swelling of the legs and abdomen and shortness of breath.
How does colchicine help pericarditis?
Colchicine is an anti-inflammatory agent that works by inhibiting tubulin polymerization, thereby interfering with migration and phagocytosis and reducing the inflammatory cycle. For acute pericarditis, colchicine is generally used in combination with other therapies.
What is the best medicine for pericarditis?
Stronger medicine may be needed if the pain is severe. Your doctor may prescribe a medicine called colchicine and a steroid called prednisone . If a bacterial infection is causing your pericarditis, your doctor will prescribe an antibiotic or other medicine.
What to do if you have pericarditis?
If a bacterial infection is causing your pericarditis, your doctor will prescribe an antibiotic or other medicine. You may need to stay in the hospital during treatment so your doctor can check you for complications.
How long does it take for pericarditis to go away?
Some cases, if not treated, can lead to chronic pericarditis and serious problems that affect your heart. It can take weeks or months to recover from pericarditis.
How is tamponade treated?
Cardiac tamponade is treated with a procedure called pericardiocentesis, in which a needle or tube, called a catheter, is inserted into the chest wall to remove excess fluid in the pericardium. Additional procedures may also be needed to extract the fluid from around the heart. This relieves pressure on the heart.
What is the best treatment for pericarditis?
For acute or recurrent pericarditis, the patient may be given a drug called colchicine as an adjunct to NSAID therapy. This drug reduces inflammation and the severity of symptoms, as well as decreasing the risk of recurrence.
How to treat pericarditis with fever?
Treatment is generally initiated with nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, indomethacin, naproxen, or ketorolac and the patient is advised to rest for about a week or two. This regimen is sufficient to encourage recovery in 70–80% of cases.
What is the procedure to insert a balloon catheter into the pericardial space?
The technique involves inserting a balloon catheter into the pericardial space under fluoroscopic or echocardiographic guidance and is quite successful in preventing recurrent effusions.
How long does pericardial drainage take?
Catheter drainage may be required for several days at a stretch, and it is generally accepted that the catheter should not be removed unless the daily (24-hr) drainage is less than 20–30 ml.
What is the procedure for decompression of the pericardium?
In selected cases, surgical decompression of the pericardium may be attempted either by routine heart surgery or by video-assisted thoracoscopy. This technique, referred to variously as pericardiotomy, pericardiostomy, or window pericardiectomy, is used selectively.
What is the state of inflammation of the pericardium?
Pericarditis is defined as the state of inflammation or infection of the pericardium, the membranous sac that encloses the heart. The cause and severity of pericarditis determines the type of treatment appropriate for this condition.
When is pericardiectomy resorted to?
Surgical removal of the entire pericardium ( pericardiectomy) is resorted to only when a patient has recurrent pericarditis and is refractory to appropriate medical treatment, or has recurrent cardiac tamponade.
What are the criteria for pericarditis?
The diagnosis of acute pericarditis should be based on the presence of at least two of the following four criteria: 1) characteristic chest pain, 2) pericardial friction rub, 3) characteristic electrocardiographic changes, and 4) new or worsening pericardial effusion. Laboratory workup, including assessment for inflammation and myocardial damage, is also recommended. Cardiac magnetic resonance (CMR) may be helpful when the diagnosis is uncertain, echocardiographic imaging is challenging, or myocardial involvement is suspected.
How long does it take for pericarditis to heal?
Acute pericarditis should be treated with a nonsteroidal anti-inflammatory drug (NSAID), typically with a 2- to 4-week taper after the resolution of symptoms. In addition, a 3-month course of colchicine (with weight-adjusted dosing) is recommended to reduce the risk of recurrent pericarditis. Strenuous activity should be avoided.
What is the most common form of pericardial disease?
Pericarditis refers to inflammation of the pericardial layers and is the most common form of pericardial disease. Causes may be infectious (tuberculosis remains the most common cause in developing countries) or noninfectious, but most cases remain idiopathic.
Can pericarditis be managed in the outpatient setting?
Most cases of pericarditis may be managed in the outpatient setting. Patients with one of the following high-risk features, however, should be admitted to the hospital for treatment: high fever (>38°C), subacute onset, large pericardial effusion or tamponade, lack of response to anti-inflammatory therapy after 1 week of treatment, and evidence for myocardial involvement. Additional predictors of elevated risk include immunosuppression, oral anticoagulation, and trauma.
When is a course of anti-inflammatory therapy indicated?
When there is evidence of inflammatory constrictive pericarditis, a course of anti-inflammatory therapy is indicated, in addition to cautious diuresis in patients with evidence of volume overload. When the constrictive process is chronic, without evidence for active inflammation, radial pericardiectomy may be required.
Is purulent pericarditis life threatening?
Purulent pericarditis is a rare but potentially life-threatening disease. It requires specific antimicrobial treatment according to the causative etiologic agent, along with pericardial drainage.
Can corticosteroids be used for autoimmune disease?
Corticosteroids have been associated with a more prolonged disease course and a higher risk of recurrence. Accordingly, their use (at low doses) should be reserved for patients unable to take NSAID therapy or for those with specific indications (e.g., autoimmu ne disease, pregnancy, or immune checkpoint inhibitor-associated pericarditis).
What is the first line of treatment for acute pericarditis?
Aspirin or NSAIDs are recommended as first-line therapy for acute pericarditis with gastroprotection.
How long does pericarditis last?
The task force suggests that the term 'acute' should be adopted for new-onset pericarditis, 'incessant' for pericarditis with symptoms persisting for four to six weeks, and 'chronic' for pericarditis lasting more than three months [3]. Recurrent pericarditis is diagnosed with a documented first episode of acute pericarditis, a symptom-free interval of four to six weeks or longer and evidence of subsequent recurrence of pericarditis. The recurrence rate after an initial episode of pericarditis ranges from 15 to 30%, and may increase to 50% after a first recurrence in patients not treated with colchicine, particularly if treated with corticosteroids [15].
What is the proposed triage of acute pericarditis?
Proposed triage of acute pericarditis according to epidemiological background and predictors of poor prognosis at presentation (at least one predictor of poor prognosis is sufficient to identify a high-risk case). Major criteria have been validated by multivariate analysis, minor criteria are based on expert opinion and literature review. Cases with moderate risk are defined as those without a negative prognostic predictor, but incomplete or lacking response to NSAIDs therapy. Low risk includes those without a negative prognostic predictor and good response to NSAIDs therapy. Specific aetiology is intended as non-idiopathic.
Can chest radiation cause pericarditis?
Chest radiation is an important cause of pericardial disease [1]. Soon after radiation, the patient may develop acute pericarditis with or without effusion. Recommendations for the prevention and management include radiation therapy methods that reduce both volume and dose of cardiac irradiation whenever possible, and consideration for pericardiotomy due to radiation-induced constrictive pericarditis [3]. The outcome of pericardiotomy is not satisfactory other than when performed for constrictive pericarditis of other causes because of co-existing myopathy.
Is pericarditis autoimmune?
Approximately 5-11% of patients with acute pericarditis may have a systematic autoimmune disease [1]. Acute pericarditis could be the first manifestation of systemic lupus erythematosus. Pericardial involvement is common in Sjögren’s syndrome, rheumatoid arthritis and sclerodermia, but may also be present in systemic vasculitis, Behçet’s syndrome, sarcoidosis and inflammatory bowel diseases. The treatment is especially targeted to the control of systemic disease [7]. The insignificant response to colchicine and the need for adjunctive immunosuppressive agents are clues to the possible presence of autoinflammatory disease [16]. In some of these conditions, anti-IL or anti-TNF agents may be considered.
Can pericardial effusions recur?
Purulent pericardial effusions are likely to recur [1]. Surgical drainage with construction of a window is often needed. In patients with thick, purulent effusions and dense adhesions, extensive pericardiectomy may be required to achieve adequate drainage and to prevent the development of constriction. Early surgical drainage may also help prevent late constriction. Intrapericardial streptokinase has been administered to selected patients with purulent or loculated effusions and may obviate the need for a window [9]. The prognosis of bacterial pericarditis is poor with survival in the range of 30%, even in modern series [3].
Is TB pericarditis rare?
Bacterial pericarditis is relatively uncommon in clinical practice in developed countries with a low prevalence of TB. Tuberculous pericarditis is the most common form all over the world and the most common cause of pericardial diseases in developing countries [1]. The management of TB pericarditis includes a couple of steps [7]. Tuberculosis not endemic in the population requires systematic investigation and fails to yield a diagnosis of TB pericarditis. In this case, there is no justification for starting anti-TB treatment empirically. In endemic areas, empiric anti-TB chemotherapy is recommended for exudative pericardial effusion after excluding other causes such as malignancy, uraemia, trauma, purulent pericarditis, and autoimmune diseases [11]. Adjunctive steroids may be considered in HIV-negative cases of TB pericarditis and avoided in HIV-associated TB pericarditis. Therapeutic pericardiocentesis is absolutely indicated in the presence of cardiac tamponade. A 'therapeutic'
What is pericarditis management?
● In cases of pericarditis due to an identifiable cause (eg, bacterial infection or malignancy), management is focused upon the underlying disorder and, if necessary, drainage of an associated pericardial effusion. (See 'Treatment' above.)
What percentage of patients with pericarditis are not treated with colchicine?
Approximately 15 to 30 percent of patients with idiopathic acute pericarditis who are not treated with colchicine develop either recurrent or incessant disease. Immune mechanisms appear to be of primary importance in the majority of cases, and the term "chronic autoreactive" pericarditis has been used.
What are the risk factors for recurrent pericarditis?
Risk factors for recurrent pericarditis include lack of response to nonsteroidal anti-inflammatory drugs, the need for corticosteroid therapy, and creation of a pericardial window. The pathogenesis, course, and treatment of recurrent pericarditis are discussed separately. (See "Recurrent pericarditis" .)
What is the pericardium made of?
The pericardium is a fibroelastic sac made up of visceral and parietal layers separated by a (potential) space, the pericardial cavity. In healthy individuals, the pericardial cavity contains 15 to 50 mL of an ultrafiltrate of plasma. Diseases of the pericardium present clinically in one of several ways:
Can glucocorticoids be used for pericarditis?
Glucocorticoids — Glucocorticoids should be used for initial treatment of acute pericarditis only in patients with contraindications to NSAIDs, or for specific indications (ie, systemic inflammatory diseases, pregnancy, and possibly renal failure), and should be used at the lowest effective dose.
Does colchicine help with pericarditis?
While the majority of patients have prompt resolution of symptoms without recurrent pericarditis when treated with NSAIDS alone, colchicine, when used as an adjunct to NSAID therapy, reduces symptoms, decreases the rate of recurrent pericarditis, and is generally well tolerated.
Is it necessary to search for pericarditis?
Because of the relatively benign course associated with the most common causes of pericarditis (>80 percent of cases), it is not necessary to search for the etiology in all patients. As such, most patients are treated for a presumptive viral cause with nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine.
Types of Treatment
Other Types of Treatment
Can Pericarditis Be Prevented?
Living with Pericarditis
Specialist to consult
Nonsteroidal Anti-Inflammatory Drugs
- To diagnose pericarditis, a health care provider will usually examine you and ask questions about your symptoms and medical history. A stethoscope is typically placed on the chest and back to listen to heart sounds. Pericarditis causes a specific sound, called a pericardial rub. The noise o…
Colchicine
Corticosteroids
Interventional Therapies
Pericardiocentesis
Pericardiectomy
- If you have serious complications from pericarditis, you may need treatments that require hospital stays. Cardiac tamponade is treated with a procedure called pericardiocentesis, in which a needle or tube, called a catheter, is inserted into the chest wall to remove excess fluid in the pericardium. Additional procedures may also be needed to extrac...
Other Techniques
- Acute pericarditis can’t be prevented. You and your doctor can take steps to reduce your chance of having another acute episode, complications or chronic pericarditis. These steps include getting prompt treatment, following your treatment plan and getting ongoing medical care as needed.
References
- Pericarditis is often mild and goes away on its own. Some cases, if not treated, can lead to chronic pericarditis and serious problems that affect your heart. It can take weeks or months to recover from pericarditis. Full recovery is most likely with rest and ongoing care, which can help reduce your risk of getting it again. Learn more: 1. Angina pectoris (chest pain) 2. View an anima…
Further Reading