Pericarditis is inflammation of the pericardium – the thin sac surrounding the heart. This condition presents with characteristic chest pain and can range from self-limited viral pericarditis to life-threatening constrictive physiology. Livasa Hospital provides comprehensive pericarditis evaluation and management with advanced imaging and specialist expertise.

Understanding Pericarditis

The pericardium consists of visceral and parietal layers surrounding the heart. Inflammation of this sac causes:

• Chest pain – Pleuritic, positional quality

• Pericardial effusion – Fluid accumulation

• Tamponade – Haemodynamic compromise from fluid accumulation

• Constrictive physiology – Chronic fibrosis restricting ventricular filling

Aetiology

Common causes:

• Viral – Most common; enterovirus, adenovirus, influenza

• Idiopathic – No identifiable cause

• Post-cardiac injury – Following MI, cardiac surgery, cardiac trauma

• Autoimmune – Systemic lupus erythematosus, rheumatoid arthritis

Less common causes:

• Bacterial (purulent pericarditis)

• Malignancy (metastatic or primary)

• Renal failure

• Tuberculosis

• Hypothyroidism

Clinical Presentation

Acute pericarditis:

• Sharp, pleuritic chest pain

• Pain relieved by sitting forward, worsened by lying back

• May have fever

• Pericardial friction rub on auscultation

With effusion:

• Muffled heart sounds

• Signs of tamponade if fluid accumulates rapidly

Constrictive pericarditis:

• Dyspnoea and fatigue

• Exercise intolerance

• Elevated venous pressure

• Hepatomegaly

Diagnostic Evaluation

ECG:

• Diffuse ST-segment elevation (characteristic)

• PR-segment depression

Echocardiography:

• Detection of pericardial effusion

• Assessment of haemodynamic significance

• Monitoring of fluid accumulation

Cardiac MRI:

• Tissue characterisation

• Myocardial involvement assessment

• Fibrosis detection in constrictive pericarditis

Labs:

• Elevated inflammatory markers

• Viral serologies if appropriate

Management

Acute pericarditis:

• NSAIDs (indomethacin, ibuprofen)

• Colchicine (reduces recurrence)

• Activity restriction

• Treating underlying cause

Pericardial effusion with tamponade:

• Pericardiocentesis – Needle drainage of fluid

• Emergency procedure if tamponade physiology

• Provides fluid for diagnostic analysis

Recurrent pericarditis:

• Extended NSAID and colchicine therapy

• Consider immunosuppression in severe cases

Constrictive pericarditis:

• Pericardiectomy – Surgical removal of fibrotic pericardium

• Definitive treatment for severely symptomatic disease

Pericardiocentesis Procedure

For significant effusions:

1. Echocardiographic guidance for safe puncture

2. Needle insertion, typically subxiphoid approach

3. Catheter placement for fluid drainage

4. Fluid collection for analysis (culture, cytology, protein)

5. Haemodynamic monitoring during drainage

Why Choose Livasa Hospital?

• Experienced cardiologists in pericardial disease

• Advanced echocardiographic assessment

• 24x7 pericardiocentesis capability

• Cardiac surgical expertise for pericardiectomy

NAP – Contact Details

Livasa Hospital Mohali
Sector 71, Sahibzada Ajit Singh Nagar (SAS Nagar)
Mohali, Punjab – 160071
Phone: +91-80788 80788 (24/7 Emergency)
Website: www.livasahospitals.com

Call +91-80788 80788 for pericarditis evaluation at Livasa Hospital.