Treatment of Acute Pericarditis

Treatment Options for Acute Pericarditis

Pain Management: Rest and oxygen therapy are typically recommended for patients experiencing acute pericarditis. Pain relief is a crucial aspect of treatment, and medications such as strong analgesics like pethidine or morphine may be prescribed to manage discomfort effectively.

Anti-inflammatory Therapy: For cases of acute nonspecific pericarditis, nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or indomethacin are commonly used. These medications help reduce inflammation and relieve pain, playing a key role in managing the condition.

Pericardiocentesis: In situations where pericardial effusion leads to cardiac tamponade—a life-threatening complication—prompt drainage of the excess fluid via pericardiocentesis is necessary. This procedure helps relieve pressure on the heart and restore normal cardiac function.

Antituberculous Therapy: In cases where pericarditis is caused by tuberculosis, aggressive antitubercular treatment is required. This typically involves a multi-drug regimen tailored to combat the infection and prevent further complications.

Classifications of Acute Pericarditis

Fibrinous Pericarditis

Fibrinous pericarditis is often marked by severe chest pain localized to the precordial area. A key clinical sign is the presence of a pericardial friction rub, which can be detected during a physical examination. This type typically does not involve significant fluid accumulation around the heart.

Effusive Pericarditis

As the condition progresses to the effusive stage, fluid begins to accumulate in the pericardial space. This phase is associated with a gradual reduction in chest pain but may lead to symptoms of pericardial tamponade. Large volumes of fluid can cause right-sided heart failure, with signs such as abdominal distension, poor appetite, leg swelling, and jugular venous distension. A notable indicator is Kussmaul's sign, where jugular venous pressure increases during inspiration.

If a significant effusion leads to cardiac tamponade, patients may exhibit Beck's triad—characterized by jugular venous distension, hypotension, and muffled heart sounds. In such critical cases, immediate pericardiocentesis is essential to stabilize the patient and prevent further deterioration.