Does your chest hurt? Is it hard to breathe? This could be Acute Pericarditis!

Have you ever suddenly felt nauseous , had chest pain, and had difficulty breathing? Perhaps the pain gets worse when you lie down, and gets better when you bend forward? If you have these symptoms, it could be an inflammation of the pericardium, which doctors call Acute Pericarditis . Don't worry, we'll talk about this in a simple way that you can understand.

What is Acute Pericarditis?

Simply put, acute pericarditis is an inflammation, or swelling, of the pericardium , the sac that surrounds the heart. It usually causes chest pain, which can be worse when you lie down or take a deep breath. The good news is that it can often be treated, depending on the cause, and most people with this condition recover without major complications.

So what is this pericardium?

Think about it, our heart is like a precious jewel. There is a small sac around this jewel to protect it. That sac is called the pericardium . This is a double-layered sac. This helps to keep the heart in one place inside our chest. Also, there is a thin layer of fluid between the heart and the inner layer of this sac. This fluid layer reduces the friction that occurs when the heart beats. To be precise, it provides protection and cushion-like support to the heart. However, it is possible to live without a pericardium. Some people are born without a pericardium, while others live healthy lives even if it is removed surgically.

How does this situation affect our bodies?

Normally, there is enough space inside this pericardium for the heart to fill with blood and expand during a heartbeat. Pericarditis alone is not a big deal. However, it can cause dangerous complications. Do you know how? The problem occurs when fluid accumulates inside the pericardium – we call it pericardial effusion – and that fluid starts to press on the heart.

Imagine, when the pericardium swells and fills with fluid, the space for the heart is reduced. When this happens, sometimes the pericardium stretches, allowing extra fluid to enter and the heart to beat properly. But if this happens suddenly, quickly, the fluid compresses the heart. Then the heart doesn't have enough room to expand, so it can't fill with blood properly. This reduces the amount of blood the heart can pump. We call this condition cardiac tamponade . This is a life-threatening medical emergency. This tamponade can cause the heart to stop, and it can be fatal within minutes.

Who can grow this much?

Acute Pericarditis can occur at any age, but it is more common in men. It is also more common in people between the ages of 20 and 50.

How common is this condition?

Acute pericarditis is a very common condition , accounting for only 5% of patients presenting to the emergency department with chest pain.

What are the symptoms of this?

Acute Pericarditis can have several symptoms. Some of the symptoms depend on the underlying cause. Possible symptoms include:

• Chest pain (we'll talk more about this below).
• Fever .
• Difficulty breathing (Dyspnea).
• Tachycardia or palpitations – this means feeling your heart beating without any effort.
• Muscle aches and pains (like a viral infection), especially in the last few days.
• Hiccups or difficulty swallowing (Dysphagia).
• Dry cough .

Let's learn specifically about chest pain.

The main symptom of acute pericarditis is chest pain . Although this pain is very similar to the chest pain that occurs during a heart attack, there are some important differences. The pain that occurs with acute pericarditis usually has these characteristics:

• Rapid onset: This symptom can come on very quickly, with full pain occurring within an hour or two.
• It can vary from person to person: this pain may be sharp for some, and dull for others.
• Spreading to surrounding areas: As with a heart attack, this pain often spreads to surrounding body parts.
• Changes with your posture: Acute pectus pain tends to get worse when you lie down and get better when you sit up or bend forward . This is one of the main symptoms that can distinguish it from heart attack pain.

Other symptoms

Other symptoms may occur with acute pericarditis. However, they depend on the underlying condition. That is, pericarditis may be caused by another disease, and pericarditis may cause other symptoms.

What causes this?

There are many possible causes of acute pericarditis. Some potential causes include:

• Infections: These include bacterial infections, especially tuberculosis , and viral infections such as HIV . Fungi or parasites can also cause peritonitis, but such infections are very rare.
• Cancer: Pericardial cancer is possible, but it is rare. Pericarditis can also occur if cancer cells develop elsewhere in the body and spread to the pericardium.
• Immune system diseases or inflammatory conditions: For example, conditions like lupus , rheumatoid arthritis , or Sjögren's syndrome .
• Hormonal disorders or problems: Things like hypothyroidism and ovarian hyperstimulation syndrome.
• Trauma: Trauma to the chest (such as a blow or a penetrating wound such as a knife or gunshot wound) can cause the pericardium to become injured and inflamed.
• Heart disease or circulatory system problems: Conditions such as heart attacks or aortic dissection .
• Medical causes: Acute pericarditis can occur after heart surgery, radiation therapy for cancer, or as a side effect of certain medications.
• Other causes: Acute pericarditis can occur with conditions such as heart failure, chronic kidney disease or kidney failure, liver cirrhosis, or for no known reason (idiopathic) .

Is this contagious?

Although acute pericarditis can be caused by a contagious infection, you cannot spread this condition to or catch it from someone else.

How do you recognize this?

A doctor can diagnose acute pericarditis based on your medical history, symptoms, a physical examination, and a combination of diagnostic tests and laboratory tests.

Typically, two or more of the following five signs and symptoms must be present to diagnose this:

• Chest pain.
• Pericardial friction rub: This is the sound of your pericardium rubbing against the inside of your chest wall. This sound is not normally heard. A doctor can hear this sound when they listen to your breathing with a stethoscope.
• Changes in electrical activity: Your heart's electrical activity occurs in a specific pattern. This can be detected by an electrocardiogram (ECG or EKG) . In acute pericarditis, the ECG shows specific changes that last for days, sometimes weeks.
• New or increasing pericardial effusion: This means a new accumulation of fluid inside the pericardium or an increase in the amount of fluid that already exists.
• Pericarditis: This can be seen on special cardiac MRI images and/or blood tests.

What tests are done to diagnose this condition?

There are many tests that can help diagnose acute pericarditis. The tests you have will depend on your symptoms, your doctor's suspicions, and other health conditions you have. The tests that may be done include:

Laboratory tests

These tests look for changes in your blood and signs of certain infections. These usually include:

• Complete blood count with differential.
• Troponin.
• C-reactive protein (CRP).
• Erythrocyte sedimentation rate (ESR).
• Immune system tests to check for autoimmune diseases.
• Tuberculin test to check for tuberculosis .
• Blood cultures to check for bacterial infections.
• Blood urea nitrogen (BUN) level and creatinine clearance tests.

Diagnostic tests

These tests can determine whether you have acute pericarditis and provide valuable clues as to why it has developed.

• Electrocardiogram (ECG or EKG): This involves placing sensors called electrodes (usually 10) on the skin of the chest and recording the heart's electrical activity as waves on paper or a screen. Doctors can look at these waves to determine if there are any abnormalities.
• Pericardial biopsy: Taking a tissue sample from the pericardium and examining it can sometimes help determine the underlying cause.
• Pericardiocentesis: This is a procedure to remove excess fluid from the pericardial sac if you have pericardial effusion and/or cardiac tamponade . Analyzing this fluid can also help determine what caused the condition in the first place.

Imaging tests

Some imaging tests can detect acute pericarditis, while others can only detect complications that may arise from it. Imaging tests that may be done include:

• Chest X-rays.
• Computerized tomography (CT) scan.
• Magnetic resonance imaging (MRI).
• Echocardiogram.

How can this be treated? Can it be cured?

Treatment for acute pericarditis depends on the cause. If there is a specific underlying cause, treatment will be directed at that cause and the symptoms that are contributing to the pericarditis. Your doctor is the best person to explain this to you, as they can tailor the treatment to your specific situation.

What kind of medication or treatment is used?

If doctors cannot find a specific cause for acute pericarditis, treatment focuses on controlling the symptoms.

One or more of the following may be used to treat these symptoms:

• Medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) are often the first-line treatment. Examples include ibuprofen and aspirin . Colchicine is another anti-inflammatory drug that is given in combination with NSAIDs . If these don't work, steroids are an option. However, these come with a slightly higher risk of side effects. Your doctor may also prescribe medication to protect your stomach lining, as continued use of NSAIDs can damage it. If the medications mentioned above don't help your symptoms, your doctor may recommend a type of medication called biologics . These are powerful medications, but they can have side effects. It's a good idea to ask your doctor if this treatment is right for you.
• Pericardiocentesis: This procedure is useful if a pericardial effusion has developed due to acute pericarditis, especially if the underlying cause is an infection or cancer.
• Surgery (Pericardiectomy): In rare cases, pericarditis can cause so much damage to the pericardium that the best option is to surgically remove it. This surgery, called a pericardiectomy, removes part or all of the pericardium. It is possible to live without a pericardium without any long-term side effects.

Your doctor may also advise you to change your daily routine and rest until you recover from this condition.

What are the complications/side effects of the treatment?

The complications that can occur from treatment depend on the treatment you receive, especially the medications. Your doctor can best explain these and the complications that can occur. He or she can also guide you on what you can do to avoid these complications and what to do if they occur.

How can I take care of myself and manage my symptoms?

Since the symptoms are similar to those of a heart attack, do not try to diagnose or manage this yourself without seeing a doctor. A heart attack is a life-threatening medical emergency, so if you have chest pain, assume it could be a heart attack. If it is not acute pericarditis, delaying treatment for a heart attack can cause permanent damage to your heart.

Important: If you experience chest pain, seek medical advice immediately, as it could be a heart attack. Do not self-diagnose.

How soon will I feel better after treatment?

Depending on the severity of your condition, the underlying cause, and the treatment used, the time it takes for you to recover from Acute Pericarditis will vary. Typically, most people start to feel better after one to three weeks of treatment , but it can take months to fully recover.

How can I prevent this?

Acute Pericarditis is a condition that cannot be prevented because it occurs unexpectedly. The only thing you can do is reduce your risk by avoiding the situations or causes that can cause it.

How can I reduce my risk?

The only way to prevent peccaditis is to avoid the things that can cause it. Here are some ways you can do this:

• Get treatment for bacterial infections: Untreated bacterial infections can cause serious damage to your body, especially your heart and nearby organs. If you suspect you have a bacterial infection, it is important to get it diagnosed and treated quickly.
• Avoid injuries: Using proper safety equipment, especially wearing a seat belt when riding in a car, is a key way to prevent acute peccadillos from chest injuries. This also includes being careful when working with tools or machinery that can cause serious chest injuries.
• Follow your doctor's instructions: Seeing your doctor as recommended, and taking your medications/treatments as prescribed, can help prevent your peritonitis from recurring or becoming chronic. This is especially true if you have a health condition that increases your risk of developing acute peritonitis.

What can I expect if I have this condition, and can this be cured?

Acute pericarditis is often a treatable and curable condition . Most people recover after treatment. Between 20% and 50% of people will have this condition more than once. However, some anti-inflammatory treatments can reduce the risk of it recurring.

Depending on the cause of your acute pericarditis, you may be at increased risk of developing a complication called constrictive pericarditis . This is when the pericardium becomes thickened and less elastic due to scarring. This can limit the heart's ability to pump blood. This occurs in 20% to 30% of people with acute pericarditis caused by tuberculosis or bacterial infections. This rate drops to 2% to 5% in people with pericarditis related to cancer or immune system diseases. It occurs in less than 1% of people with acute pericarditis of unknown cause or caused by a viral infection.

How long will this condition last, and when can I resume my normal activities?

Untreated acute pericarditis can lead to other conditions, some of which can be more serious and dangerous. Therefore, do not leave this condition untreated.

With treatment, acute pericarditis should get better within a few weeks. However, many people will need to stop physical activity – including exercise and sports – until their symptoms improve. It is common for symptoms to return if they start exercising too soon. Your doctor will explain what to expect and will schedule follow-up appointments to monitor your recovery to see if there are any problems.

When should I see my doctor and when should I seek medical help?

If you have had acute pericarditis before, watch for signs of recurrence during your recovery, or for signs of change or worsening. If you have these symptoms, call your doctor, or seek medical attention outside of their office hours.

The main symptoms to watch out for are:

• Chest pain. *
• Fever.
• Difficulty breathing (Dyspnea).

*> This symptom could be a sign of a heart attack, so you should call 1990 (or your local emergency number) immediately.

Acute Pericarditis is a condition that often causes pain. Although it is usually not a serious condition on its own, it has symptoms similar to a heart attack, which is a medical emergency. It can also be associated with other conditions, such as cardiac tamponade, which is a medical emergency. Because of these similarities and associations, it is important to get these symptoms checked by a doctor. If you have acute pericarditis, it can usually be treated, but some people may have more than one episode.

Take-Home Message

Okay, so we've talked a lot about Acute Pericarditis. The most important thing to remember is that if you have chest pain, especially pain that gets worse when you lie down and gets better when you bend forward, along with symptoms like shortness of breath and fever, don't take it lightly.

It could be a heart attack, so seek medical advice immediately.

Acute pancreatitis is often a curable condition, but proper treatment is essential.

Follow the doctor's instructions exactly, rest for the prescribed period, and take your medication correctly.

If you have any further questions about this, don't hesitate to talk to your doctor. Stay healthy!

` Pericarditis, Acute Pericarditis, Chest Pain, Heart Disease, Shortness of Breath, Fever, Palpitations, Cardiac Tamponade, Pericardial Effusion