Treatment Options for Pericarditis: A Comprehensive Guide

Pericarditis, an inflammation of the pericardium, can occur in different forms, with the most common being acute pericarditis and chronic constrictive pericarditis. Understanding the type of pericarditis is essential for determining the most effective treatment approach.

Acute Pericarditis: Symptoms and Management

Acute pericarditis often presents with sudden onset chest pain and may be accompanied by a pericardial effusion — a buildup of fluid around the heart. When a significant amount of fluid accumulates, it can lead to cardiac tamponade, a serious condition that impairs heart function. In such cases, pericardiocentesis (a procedure to drain the excess fluid) is typically recommended to relieve pressure and alleviate symptoms.

Medications for Pain and Inflammation

For pain management, nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed. Aspirin is often the first-line treatment for its anti-inflammatory and analgesic properties. If symptoms persist or are not adequately controlled with aspirin, alternative NSAIDs such as ibuprofen or indomethacin may be used. In more severe cases where pain is unresponsive to these medications, opioids like morphine may be considered to provide relief.

Chronic Constrictive Pericarditis: Long-Term Treatment

Chronic constrictive pericarditis is a progressive condition that usually develops after repeated episodes of acute pericarditis. Over time, the pericardium becomes thickened and rigid, restricting the heart's ability to expand properly. The primary treatment for this condition is surgical pericardiectomy — the removal of the diseased pericardium — which can significantly improve heart function and quality of life.

Post-Surgical Care and Special Considerations

In cases where constrictive pericarditis is caused by tuberculosis, it is crucial to continue antituberculosis therapy following surgery. This helps prevent recurrence and ensures a more complete recovery. Close monitoring by a healthcare provider is essential to manage complications and support long-term heart health.