Pericarditis occurs when the sac around the heart, called the pericardium, becomes inflamed (damaged from infection or irritation). Fluid from the inflammation can increase pressure on the heart, squeezing it and making it harder to pump blood to the body.
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The March 5, 2003, issue of JAMA includes an article about pericarditis.
Infections
Damage from chest injuries or surgery
Radiation treatment to the chest area
Uremia (waste products building up in the blood due to kidney disease)
Rheumatoid arthritis or lupus (a disorder involving inflammation of the skin and other tissues)
Cancer
Heart attacks Sometimes no specific cause can be determined.
Sharp, piercing chest pain, especially behind the breast bone, spreading to the neck, the left shoulder, and the muscle ridges between the neck and shoulders
Pain intensifies when the person takes a deep breath
Pain tends to decrease when sitting up
Pain with swallowing
Fever
Careful history taking of the symptoms and a physical examination by a doctor are very important. An electrocardiogram and another heart test called an echocardiogram often provide useful information.
Medications such as ibuprofen and colchicine are often effective for treating the pain and inflammation of pericarditis. If pericarditis is found to be caused by a bacterial infection, antibiotics are given. If the excess fluid in the pericardium seriously affects the heart’s ability to pump blood, a needle or catheter (tube) may be inserted to remove the fluid in a procedure called pericardiocentesis. In some cases, surgery is needed to relieve the pressure. Depending on the underlying cause, pericarditis usually subsides in one month or less. However, if pericarditis is caused by a disease like lupus or rheumatoid arthritis, it can persist for longer periods of time.
American Heart Association 800/242-8721 www.americanheart.org
• National Heart, Lung, and Blood Institute 301/592-8573 www.nhlbi.nih.gov
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Sources: American Heart Association; National Heart, Lung, and Blood Institute
Topic: HEART DISEASE
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