Can acute pericarditis be cured?

Written by Liu Ying
Cardiology
Updated on September 10, 2024
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Patients with acute pericarditis should identify the cause of pericarditis and treat accordingly, rest in bed until chest pain and fever subside, administer analgesics for pain relief, and if pericardial effusion occurs, administer corticosteroids for patients who do not respond well to other medications for absorbing effusion. In cases of excessive pericardial effusion leading to acute cardiac tamponade, immediate pericardiocentesis and fluid drainage are necessary. For persistent recurrent pericarditis lasting over two years, and in patients who cannot be controlled with steroids, or those with severe chest pain, surgical pericardiectomy may be considered as a treatment option.

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Written by Liu Ying
Cardiology
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Pericarditis is caused by what?

Pericarditis refers to the inflammatory disease of the visceral and parietal layers of the pericardium. It can be classified according to its etiology into infectious, non-infectious, allergic, and immune pericarditis. Causes of infectious pericarditis include viral, purulent, tuberculous, and fungal pericarditis. Non-infectious pericarditis can be caused by acute myocardial infarction, uremia, tumors, trauma, aortic dissection, radiation, acute idiopathic, and sarcoidosis, among others. Causes of allergic or immune pericarditis include rheumatic, vasculitis, drugs, and more. Some patients remain undiagnosed after examinations and are categorized as having idiopathic pericarditis or nonspecific pericarditis.

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Written by Liu Ying
Cardiology
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What are the symptoms of acute pericarditis?

Acute pericarditis is an acute inflammatory disease of the visceral and parietal layers of the pericardium. The most common causes are viral infections and bacterial infections, but autoimmune diseases and uremia can also cause acute pericarditis. Characteristic pain behind the sternum or in the precordial area is common during the fibrinous exudative phase of the inflammation. This pain is associated with respiratory movements and often worsens with coughing, deep breathing, changes in body position, or swallowing. The nature of the pain is very sharp and can radiate to the neck, left shoulder, left arm, or even the upper abdomen. As the condition progresses, symptoms can shift from the fibrinous phase pain to dyspnea during the exudative phase. Some patients may develop significant pericardial effusion, leading to cardiac tamponade, and subsequently exhibit a range of related symptoms, including dyspnea and edema.

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Written by Tang Li
Cardiology
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What are the clinical considerations for acute pericarditis?

The treatment and prognosis of acute pericarditis mainly depend on the cause, and are also related to whether it is diagnosed and treated correctly early on. For various types of pericarditis, if constrictive syndrome occurs, pericardiocentesis should be performed immediately to relieve symptoms. In cases like tuberculous pericarditis, if not treated aggressively, it can usually progress to chronic constrictive pericarditis. Acute nonspecific pericarditis and post-cardiac injury syndrome may lead to recurrent attacks of pericarditis after the initial episode, known as recurrent pericarditis, with an incidence rate of about 20%-30%. This is one of the most difficult complications of acute pericarditis to manage. Clinically, it generally presents similar to acute pericarditis, with recurrent attacks months or years after the initial episode, accompanied by severe chest pain. Most patients should be treated again with high doses of non-steroidal anti-inflammatory drugs, slowly tapering over several months until the medication can be stopped. If ineffective, corticosteroid treatment may be administered; in severe cases, intravenous methylprednisolone may be given, and symptoms in most patients may improve within a few days. However, it is important to note that symptoms often reappear during steroid tapering.

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Written by Tang Li
Cardiology
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What are the infectious causes of pericarditis?

The causes of pericarditis include the following types: first, acute nonspecific; second, tumors; third, autoimmune disorders; fourth, metabolic diseases; fifth, physical factors such as trauma and radiation; sixth, diseases of adjacent organs and tissues, such as acute myocardial infarction, pleurisy, aortic dissection, pulmonary embolism, etc. The infectious causes of acute pericarditis mainly include viruses, bacteria, fungi, parasites, and rickettsiae. Common types of pericarditis include tuberculous pericarditis and purulent pericarditis.

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Written by Tang Li
Cardiology
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What are the clinical considerations for acute pericarditis?

The treatment and prognosis of acute pericarditis depend on the cause, as well as early diagnosis and correct treatment. For various types of pericarditis, such as those presenting with tamponade syndrome, pericardiocentesis should be performed to relieve symptoms. Tuberculous pericarditis, if not actively treated, can evolve into chronic constrictive pericarditis. Patients with acute nonspecific pericarditis and post-cardiac injury syndrome may experience recurrent pericarditis after their initial episode, which is the most challenging complication of acute pericarditis. Clinically, it presents similarly to acute pericarditis, with recurrent episodes months to years after the initial onset, accompanied by severe chest pain. Most patients can be treated again with high doses of non-steroidal anti-inflammatory drugs, slowly tapering to normal over several months. If ineffective, corticosteroid therapy may be administered. (Medications should be used under the guidance of a doctor according to specific circumstances.)