Treatment of Pericarditis

Understanding Pericarditis and Its Management

Pericarditis is an inflammatory condition affecting the pericardium, often triggered by viral or bacterial infections, as well as physical, chemical, or immune-related injuries. This inflammation may lead to fluid accumulation, resulting in a range of clinical symptoms. Effective treatment strategies are essential to manage the condition and improve patient outcomes.

1. Identify and Treat the Underlying Cause

Accurately diagnosing the root cause of pericarditis is crucial. This includes identifying whether the cause is viral, bacterial, tuberculous, or related to uremia. Proper diagnosis allows for targeted treatment of the primary condition, which in turn can significantly improve symptoms and long-term prognosis. For example, bacterial pericarditis may require antibiotic therapy, while uremic pericarditis might improve with dialysis or other renal support measures.

2. Symptomatic Relief for Chest Pain

Chest pain is a common symptom among pericarditis patients. To manage discomfort, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or indomethacin are often prescribed. In some cases, stronger pain relievers like opioids may be used cautiously to alleviate severe pain and improve patient comfort.

3. Drainage for Pericardial Effusion and Cardiac Tamponade

If pericardial effusion leads to low blood pressure or cardiac tamponade—a life-threatening condition where fluid buildup compresses the heart—immediate intervention is necessary. Procedures such as pericardiocentesis (fluid drainage) or pericardial window surgery may be performed to relieve pressure and prevent sudden cardiac complications.

4. Surgical Intervention for Chronic Constrictive Pericarditis

In cases of chronic pericarditis where the heart's ability to expand and fill with blood is significantly impaired, surgical pericardiectomy may be recommended. This procedure involves removing the thickened or scarred pericardium, thereby improving heart function and overall hemodynamics.

5. Managing Arrhythmias Associated with Pericarditis

Pericarditis can lead to various types of arrhythmias, including both rapid and slow heart rhythms. Depending on the severity, antiarrhythmic medications may be prescribed to stabilize heart rate and rhythm. Proper management of these irregularities is essential for improving hemodynamic stability and long-term patient outcomes.