What Makes Pericarditis Worse? | How To Sleep With Pericarditis?

Pericarditis is an inflammation in the pericardium. A fluid-filled sac with two layers is located in the outer part of our heart, called the pericardium. Its main function is to give comfort to our heart, to keep away from infection.

If there is inflammation in these layers, it can result in chest pain. The pericardium helps to keep your heart inside the wall of your chest.

What Makes Pericarditis Worse?

If pericarditis is not treated, it can get worse and become a more severe condition.

Cardiac tamponade: If too much liquid builds up in the pericardium, it can put more pressure on the heart, preventing it from filling with blood. If left untreated, blood pressure rises.

Constrictive pericarditis: This is a rare condition of pericarditis. Constrictive pericarditis involves permanent thickening and scarring of the pericardium.

These tissues cause stiffness, and the heart does not function properly, causing swelling in the legs and difficulty breathing.

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Types of pericarditis

There are Two types Pericarditis:

Acute pericarditis

  • It includes sudden pain, inflammation of the pericardial layer of the heart.
  • Causes of acute pericarditis include the prevention of red blood cells, white blood cells, fibrin that do not enter into the pericardial space. 

Chronic pericarditis

  • It is the infection of the pericardium layer of the heart for a long time due to the stiffness and thickening of the pericardial layer of the heart.
  • It includes chest tightness, shortness of the breath, fatigue, coughing.

Causes

Infectious: Pericarditis may be caused by:

  • Viral (coxsackievirus, influenza).
  • Bacterial (Pneumonococcus, tuberculous, staphylococcus or streptococcus).
  • Fungal (Aspergillus, Candida, & Coccidioides
  • Rheumatic fever
  • Myocardial infarction
  • Uremic pericarditis
  • Malignancy of the heart
  • Side effects of some medications, e.g., isoniazid, cyclosporine, warfarin, & heparin.
  •  Radiation-induced
  • Aortic dissection
  • Tetracyclines 
  • Postpericardiotomy syndrome: Usually after CABG surgery. 

Signs and symptoms

The Symptoms of Pericarditis can include : 

  • If an infection causes it, you may have fever, chills, or sweating.
    Your chest pain is almost always there.
    Feeling pain in the neck, shoulders, back, or abdomen.
    Pain is often felt in deep breathing.
    It hurts you to swallow, Sitting and leaning forward or bending is relieved.

Other symptoms

Must read: When To Go To The Hospital For Rapid Heart Rate?

How to sleep with pericarditis?

Sleeping on the right side is a good option for people with pericarditis. Although some people think that sleeping on your right side can re-limit blood flow to the heart, there is not enough indication to prove that it is harmful.

Diagnostic evalution

Your doctor check to Diagnosis tool may use

X-ray: X-ray will show the shape of the heart, whether it is enlarged due to fluid or not.

CT: more detail of the heart can be found than X-rays and dispels other potential problems such as pulmonary clots and erotic tears.

MRI: This radio uses waves and a magnetic field; this technique shows the width of the walls of the heart

Echocardiogram: This creates an image of the heart using sound waves.

Electrocardiogram: A wire is applied to the chest to measure the electrical activity of the heart.

Treatment

By the way, pericarditis can be treated in many ways. But the treatment of pericarditis depends on its cause. When its cause is known, it can be treated correctly. If you have a bacterial infection, you will be treated by giving antibiotics. 

Colicin

Colicin is an inflammation-reducing drug that helps reduce your symptoms and prevent pericarditis from recurring.

NSAID

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed for both pain and inflammation to treat it. These include ibuprofen or aspirin, which provide quick relief. 

Corticosteroids

It is a very effective medicine. Corticosteroids are beneficial in reducing the symptoms of pericarditis. But studies have shown that early use of corticosteroids may increase the risk of recurrence of pericarditis. 

Usually, a diuretic (“water pills”) helps you get rid of excess fluid caused by constrictive pericarditis.

Management

Surgical management

  • Pericardiocentesis
  • Hook needle to V lead- guided by EKG and echo
  • Look for ST-elevation
  • Withdraw fluid
  • Afterward watch for cardiac tamponade (PP), dysrhythmias, pneumothorax 

Complication

  • Pericardial effusion
  • Cardiac tamponade
  • Pulsus paradoxus 
  • Hypotension

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