Pericarditis, from symptoms to causes to treatment: what you need to know

Pericarditis, from symptoms to causes to treatment: what you need to know

Defense Minister Guido Crosetto was urgently hospitalized for suspected pericarditis. What is it, what does it depend on and how is it treated?


Pericarditis is defined as inflammation of the pericardium, the sac-shaped structure that contains and protects the heart, made up of two membranes separated by a very thin layer of liquid. The causes of inflammation can be multiple and the precision of the diagnosis is the first step towards effective therapy, explain from the ‘De Gasperis’ Cardio Center of the Niguarda hospital in Milan.

The causes

Pericarditis – we read in a focus on the disease – is often caused by viral infections, the same ones that cause common upper respiratory tract infections or gastroenteritis; more rarely it is caused by bacteria, fungi or parasites. But there can also be a non-infectious origin. This is the case of uremic pericarditis in people suffering from renal failure, pericarditis in the course of thyroid diseases or neoplastic pericarditis, which can complicate some tumors (lung, breast, lymphoma or leukemia). Pericarditis can also appear following a heart attack, rheumatic fever, chest trauma or invasive procedures on the heart.

The diagnosis

But how can you recognize it? The most frequent symptom of acute pericarditis is pain, generally localized in the chest or behind the sternum, but which can also radiate to the neck, left arm, back and more rarely to the abdomen. The pain can be very intense or barely noticeable. Typically it is a sharp, stabbing-like pain that can worsen with inhalation, coughing or swallowing.

The diagnosis of pericarditis is based on a series of wide-ranging tests, continues the in-depth analysis of the Niguarda Cardio Center. Cardiological examination, in particular auscultation of the heart, can already provide a suspected diagnosis.

The electrocardiographic tracing may also present characteristic alterations. The picture can be better defined with more in-depth investigations such as chest x-ray, echocardiogram (useful to ascertain the presence of pericardial effusion and the possible need to drain it), magnetic resonance imaging and specific laboratory tests.

The therapies

And the treatments? Viral or idiopathic forms (i.e. with an unknown cause) are treated with anti-inflammatory drugs (NSAIDs, colchicine, steroids); specific forms caused by bacteria, fungi or parasites require treatment of the underlying cause with targeted drugs. When the amount of pericardial effusion is large and excessively compresses the heart (cardiac tamponade), the fluid must be drained through a catheter introduced between the pericardial membranes. In the most serious and rare cases, pericardiectomy, a cardiac surgery to remove the pericardium, may be necessary.

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