Pericarditis can cause sharp chest pain and other uncomfortable symptoms. While the condition is often mild and resolves on its own, some cases require medical treatment to prevent complications and manage discomfort.

In this article, we’ll explore various treatments for pericarditis, from anti-inflammatory medications to lifestyle adjustments, and discuss when to seek professional care.

Whether you’re dealing with an acute or chronic form of pericarditis, understanding your treatment options is key to a faster recovery and a better quality of life.

Pericarditis is the inflammation of the pericardium, the thin, protective sac surrounding the heart. This condition can cause sharp, stabbing chest pain, often mistaken for a heart attack.

Pericarditis may be triggered by infections, autoimmune disorders, injury, or even heart surgery. In many cases, the inflammation is mild and resolves within a few weeks.

However, more severe or chronic cases may require long-term care and can lead to complications if untreated.

Diagnosing pericarditis begins with a thorough review of symptoms and a physical exam. Your doctor may listen for a distinctive rubbing sound called a pericardial friction rub. Diagnostic tests include:

• Electrocardiogram (ECG) to detect heart rhythm abnormalities.
• Echocardiogram to visualise fluid buildup or inflammation around the heart.
• Chest X-ray to check for heart enlargement or other abnormalities.
• Blood tests to identify signs of infection or inflammation.

Treatment for pericarditis typically starts with medications to reduce inflammation and manage symptoms. However, in more severe or complicated cases, medical procedures or surgeries may be necessary.

Below are the key treatment approaches, including when procedures are needed:

Medications

• Anti-inflammatory drugs: Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, are often the first line of treatment to reduce inflammation and alleviate pain. These medications can help resolve symptoms within a few days to weeks.

• Colchicine: This anti-inflammatory drug is frequently prescribed to prevent recurrences and to treat both acute and chronic pericarditis. It is often used in conjunction with NSAIDs.

• Corticosteroids: In cases where NSAIDs and colchicine are ineffective or contraindicated, corticosteroids like prednisone may be used. These are powerful anti-inflammatory agents but are typically reserved for more severe or recurrent cases due to potential side effects.

• Antibiotics or antifungals: If the pericarditis is caused by a bacterial or fungal infection, targeted antibiotics or antifungals will be administered.

• Immunosuppressive drugs: For patients with autoimmune disorders, medications that suppress the immune system, such as azathioprine or methotrexate, may be prescribed to control inflammation.

In more severe or complicated cases of pericarditis, particularly if there is fluid buildup or recurrent pericarditis, certain procedures or surgeries may be needed:

a)Pericardiocentesis

• What it is: This is a procedure where a needle or catheter is used to drain excess fluid from the pericardial sac (a condition called pericardial effusion). This procedure is typically guided by ultrasound to ensure precision and safety.
• When it’s needed: Pericardiocentesis is crucial in cases of cardiac tamponade, a life-threatening complication where excess fluid puts pressure on the heart, preventing it from functioning properly. It relieves the pressure and allows the heart to pump normally.

b)Pericardiectomy

• What it is: This is a surgical procedure where part or all of the pericardium is removed. It is typically performed when chronic pericarditis leads to constrictive pericarditis, where the inflamed pericardium becomes thickened and stiff, restricting the heart’s normal movement.
• When it’s needed: A pericardiectomy is usually a last resort for patients with constrictive pericarditis who haven’t responded to other treatments. The surgery can significantly improve symptoms and quality of life by relieving pressure on the heart.

c)Pericardial Window

• What it is: A pericardial window involves surgically creating a small opening in the pericardium to allow continuous drainage of excess fluid into the chest cavity, where it can be reabsorbed by the body.
• When it’s needed: This procedure is used when fluid buildup around the heart (pericardial effusion) recurs, especially in patients with cancer or other conditions that cause persistent fluid accumulation.

d)Balloon Pericardiotomy

• What it is: This less common procedure involves using a balloon catheter to create an opening in the pericardium, similar to the pericardial window but less invasive.
• When it’s needed: Balloon pericardiotomy is sometimes used as an alternative to more invasive surgical procedures for recurring fluid buildup or pericardial effusion, particularly in cases where surgery poses higher risks.