Rheumatic Pericarditis: Understanding the Causes and Symptoms

Rheumatic pericarditis is a type of acute pericarditis that occurs as part of a broader condition known as rheumatic fever. It typically develops following an infection in the upper respiratory tract, most commonly caused by Group A Streptococcus bacteria. In some cases, Staphylococcus bacteria may also play a role in triggering this inflammatory response.

Primary Causes of Rheumatic Pericarditis

One of the leading causes of rheumatic pericarditis is a recent history of upper respiratory infection. This infection, if left untreated or improperly managed, can lead to rheumatic fever—a systemic inflammatory disease that affects multiple organs, including the heart. When rheumatic fever involves the heart, it often results in pancarditis, which is the inflammation of all three layers of the heart, including the pericardium.

Connection with Rheumatic Fever

Rheumatic fever is an autoimmune reaction that occurs when the body's immune system mistakenly attacks its own tissues following a streptococcal infection. This immune response can cause inflammation in various parts of the body, including the joints, skin, brain, and heart. When the heart is affected, it leads to symptoms associated with rheumatic pericarditis.

Common Symptoms and Clinical Presentation

Patients with rheumatic pericarditis often experience fever, which is typically mild to moderate in intensity and irregular in pattern. The onset of symptoms usually occurs about one to two weeks after a prior upper respiratory infection. One of the hallmark signs of this condition is chest pain, which can be sharp and localized behind the breastbone or in the anterior chest area.

Characteristics of Chest Pain

The chest discomfort associated with rheumatic pericarditis may radiate to the neck and back, resembling the pain experienced during a myocardial infarction (heart attack). However, unlike heart attack pain, pericardial pain may improve when sitting up or leaning forward and may worsen when lying down or taking deep breaths.

Diagnosis and Medical Evaluation

Because the symptoms of rheumatic pericarditis can mimic those of other cardiac conditions, proper diagnosis is essential. Physicians often rely on a combination of patient history, physical examination, blood tests, and imaging studies such as echocardiograms to confirm the presence of pericardial inflammation and rule out other potential causes of chest pain.

Conclusion

In summary, rheumatic pericarditis is primarily triggered by untreated or inadequately treated bacterial infections, particularly those involving the upper respiratory tract. Recognizing the early signs and seeking prompt medical care can significantly reduce the risk of complications and improve overall outcomes for patients affected by this condition.