What is Pericarditis?
Pericarditis is defined as the inflammation of the pericardial sac (x). This condition can be divided into three types.
Types of Pericarditis
- Acute Pericarditis: This refers to the type of pericarditis that comes on suddenly and gets better within the coming days or weeks.
- Chronic Pericarditis: Chronic pericarditis refers to the form of pericarditis that lasts for a long period of time.
- Recurrent Pericarditis: This form of pericarditis goes away, but comes back on other occasions. This form of pericarditis occurs in roughly 30 percent of the general pericarditis cases (x).
This condition has also been linked to other pericardial conditions, like pericardial effusion, cardiac tamponade, effusive-constrictive pericarditis and constrictive pericarditis (x, x). Pericardial inflammation can also be accompanied with an increase in fluid accumulation in the pericardial sac, leading to the formation of a pericardial effusion which could be serious, purulent or hemorrhagic depending on the etiology (x). The fluid accumulated could become significant hemodynamically, especially when the pericardial effusion is large or the accumulation rate is rapid.
The most common symptom of pericarditis is chest pain. One can relieve this pain by sitting up and leaning forward. In most cases, the exact cause of pericarditis is unknown. It is possible that viral infections can cause it, but that theory remains unclear. Pericarditis can be contracted by anyone, but adults are more susceptible to the condition (x).
Symptoms of Pericarditis
A core symptom of pericarditis is a severe and constant pain in the chest. Some patients discover that they feel an aching, dull pain in their chest. A good way of alleviating this is to sit up and lean forward. The pain could also spread to the shoulders and to the neck and it could get worse if you lie down, swallow, cough or breathe in (x).
Pain in the chest can be similar to a stabbing pain that gets worse with swallowing.
Breathing Problems and Fever
There can also be issues with breathing, like coughing, breathlessness or a severe shortness of breath. Having a persistent or an intermittent fever is also a symptom of pericarditis.
Flu Like Symptoms
In addition to the above, a person with pericarditis may experience symptoms that are similar to that of a common flu. Fever, as mentioned above, as well as feeling weak, nauseous and lightheadedness can accompany a bout of pericarditis.
Similar to Heart Attack
The symptoms of pericarditis may mimic that of a heart attack, so it is important to seek medical attention if you experience any sudden chest pain. In some cases, tests may be necessary to ascertain the condition you have.
Causes of Pericarditis
According to the 2015 ESC guidelines for the diagnosis and management of pericardial diseases, the causes of pericarditis can be divided into two main groups (x):
Viruses are the most common sources of infections and these include coxsackieviruses A and B, echovirus, parvovirus B19, adenoviruses and influenza, alongside multiple herpes viruses like EBV and CMV (x, x). Certain bacteria have also been linked to being the cause of pericarditis in developed societies. However, tuberculosis infection is very rampant within developing countries and is cited as one of the most common causes of pericarditis in endemic regions of the world (x). This is true for HIV positive patients where they suffer from an increased rate of infection.
Non-infectious causes are numerous. Examples of non-infectious causes of pericarditis include malignancy, connective tissue diseases like rheumatoid arthritis and Behcet’s disease and metabolic causes like myxedema (x, x). Trauma could also cause pericarditis with early onset following injury (x).
Although some medications may induce pericarditis, the occurrence remains rare (x). Medications like hydralazine, procainamide and isoniazid may potentially cause medication-induced systemic lupus erythematosis with pericardial involvement and associated serositis masquerading as pericarditis.
In recent times, checkpoint inhibitors like nivolumab and ipilimumab have been noted for being causes of cardiac toxicity, including pericarditis and myocarditis. The two most notable classes are monoclonal antibodies to cytotoxic-T-lymphocyte-associated antigen 4 (CTLA- 4) and programmed cell death 1 (PD-1) and its ligand PD-L1, which have had several progressive applications within the oncology field (x).
Living with Pericarditis
Most people recover from pericarditis very quickly. However, it could take several months or it could never get resolved for some people. Pericarditis can reoccur regardless of surgical and medical intervention, leaving patients uncertain about the future of their health. And considering the fact that this condition is not visible or linked to living an unhealthy lifestyle, there is a vast lack of understanding between the effects of living with pericarditis. This can mean sufferers could end up feeling alone, causing them to deal with side effects like palpitations, anxiety and panic.
For many patients, living with pericarditis can be emotionally and physically challenging to deal with. But it is important to develop healthy systems to manage the stress and anxiety that come with the condition, and there are multiple support channels that can help you, including the following:
- Discuss with your doctor about enrolling for counseling or undergoing cognitive behavioral therapy.
- Talk to your family and friends to educate them about the condition so they can be there for you and help you with what you are dealing with.
Treatment for Pericarditis
Some patients who suffer from pericarditis often get better within days or weeks without having to begin any treatment (x). However, for those who don’t, there are treatment options available to deal with the condition.
Treat the Underlying Cause
The advisable treatment method is to treat the underlying cause of the condition. For example, if the condition was caused by a bacterial infection, your doctor should prescribe antibiotics to deal with the infection in a bid to cure the pericarditis.
Your doctor could also prescribe over-the counter painkillers or issue a prescription for non-steroidal anti-inflammatory drugs (NSAIDs) to deal with the pain (x). Another form of medication that could be recommended is the proton pump inhibitor (x). This is prescribed in place of NSAIDs because NSAIDs could have side effects that affect your stomach. This is avoided with the pump inhibitors. Colchicine can also help manage pain.
Colchicine can also be prescribed for patients who are dealing with recurrent pericarditis to help keep the symptoms at bay for a longer period of time. Attacks could also be shorter and have less intense symptoms (x).
Versions of pericarditis can also be treated with corticosteroid machines, but they are not effective for everyone and should be used as a last resort option. These should be prescribed by your doctor if they work for you. When undergoing treatment for pericarditis, it is important to reset and avoid all forms of stressful activity for a couple of weeks. This will go a long way in easing your symptoms and reducing the risk of abnormal heart rhythms (x).
It is important to review all medication before use to ensure it doesn’t further aggravate the condition or put you at risk for another condition.
Supplements for Pericarditis
Grapefruit Seed Extract
This supplement comes from the grapefruit seed and possesses antioxidant properties. The grapefruit seed is made up of components like flavonoids (which is the chief source of the antioxidant properties found within the fruit), vitamin C and E, limonoids, citric acid and sterols and other minerals. It is also useful in maintaining overall health by supplementing the daily intake of vitamin C and E.
The ideal dose for this supplement is one capsule per day (x).
This supplement comes from the Rhodiola plant, which is present in some arctic regions. It contains multiple amino acids and it promotes athletic endurance, improves mood and burns fat. This supplement contains a lot of flavonoids, essential oils and tannins.
Astragalus has been standardized to contain 50 percent polysaccharides, which are digestible carbohydrates that help to maintain blood sugar and cholesterol levels in the body. The recommended dose for astragalus extract powder is 1,300 mg to be taken daily with meals or as directed by your doctor (x).
This supplement is extracted from the hawthorn, which is an herb that can improve mood, heart health. It has also been known to support cardiovascular function, improve blood pressure and stabilize cholesterol levels. The berries contain flavonoids, antioxidant and anti-inflammatory agents that reduce free-radical damage. The ideal dose for hawthorn berry extract powder is 1,200 mg. Take it 1-2 times daily (x).
Possibly the most popular supplement in the world, Vitamin C, also known as ascorbic acid is known for its usefulness, especially when combined with other enzymes and solutions. The ideal dose for this supplement is 1,000 mg to be taken daily (x).
Omega-3 Fatty Acids
Omega 3-6-9 contains fish oils, flaxseed oil and evening primrose oil to benefit heart health, reduce inflammation and improve mood. The ideal dose for omega 3-6-9 is 3 gels to be taken once or twice daily or as directed by your doctor (x).
Oregano extract may promote the overall health of the urinary tract. It is also a naturally occurring antibiotic that helps fight bacterial infections. It is also a powerful antioxidant and it could help lower cholesterol levels in the body.
As a dietary supplement, the recommended dose is 2,000 mg (1 level teaspoon) daily with water, or as directed by your medical doctor. However, it is important to state that the appropriate dose for oregano extract powder depends on a lot of factors, among which includes the user’s age, health and several other conditions.
The Bottom Line
Pericarditis, if left unchecked can become a chronic and possibly life-threatening condition, which may lead to the emergence of symptoms of heart failure. Because of the similarities the symptoms that pericarditis has with other vascular conditions, it is important you confirm the diagnosis before beginning any form of medication.