Pericarditis

Vonnie · 4th June 2008, 9:20pm

Can any of the forum medics tell me what the script is with pericarditis? Is it life threatening? Is it likely to have long-term ramifications and is it likely to be a recurring issue? Does it have any effect on the risk of heart attack?

I'm not getting much sense from the medical team responsible for treatment at the moment, they don't seem capable of giving a straight answer.

N.B. It's not me who has it btw.

djbarry · 4th June 2008, 9:33pm

My wife has been working in cardiovascular research for the last 5 years, so I guess she could certainly advise, but she doesn't deem the forum worthy of her attention. If you want some information, you can always email her at her work email.

Vonnie · 4th June 2008, 9:35pm

Ahhh that would be amazing Barry - I just don't like emailing her out of the blue with medical stuff when I haven't spoken to her for a while.

bikuki · 4th June 2008, 9:36pm

Pericarditis is inflammation and infection around the heart muscle. This can cause fluid buildup in the space between the heart and the sac surrounding it (which can lead to the heart being unable to pump properly), muscle loss (resulting in heart failure) and arrythmias. Depending on the extent of the pericarditis it can have life-long ramifications and it can be life threatening, howeverseeing as they're getting treatment asap it greatly improves the prognosis. It's not generally a recurring illness.

djbarry · 4th June 2008, 9:36pm

She'll not mind at all. Do you still have her email address or do you want me to PM it to you?

**LesMTS** · 4th June 2008, 9:39pm

A brief ping around the usual sources (skim reading I admit) seems to suggest it's not terribly serious, seems the most serious treatment necessary is simple drainage of the pericardium in rare chronic cases where the heart becomes compressed.
Also, looks like it can be both a chronic or acute condition with different approaches involved for each.
Once again, I've just briefly skimmed over the most reliable internet med resources. So I'm not suggesting this is great advice.

bikuki · 4th June 2008, 9:42pm

Quote:

Originally Posted by LesMTS

A brief ping around the usual sources (skim reading I admit) seems to suggest it's not terribly serious, seems the most serious treatment necessary is simple drainage of the pericardium in rare chronic cases where the heart becomes compressed.
Also, looks like it can be both a chronic or acute condition with different approaches involved for each.
Once again, I've just briefly skimmed over the most reliable internet med resources. So I'm not suggesting this is great advice.

Actually it can be very serious, but generally isn't. I'm to frighten anyone or anything, I'm just answering truthfully.

**LesMTS** · 4th June 2008, 9:46pm

Quote:

Originally Posted by bikuki

Actually it can be very serious, but generally isn't. I'm to frighten anyone or anything, I'm just answering truthfully.

Yeah, I was just skimming review abstracts and some of the better online med resources. The gist I got was it isn't something that can't be successfully managed, and that the more serious complications are well understood and can be dealt with successfully in the vast majority of cases.

bikuki · 4th June 2008, 9:50pm

Ok, checked some stuff in a book and it's most likely to be viral pericarditis (sudden onset chest pain in young fit person, ECG looks like an MI), which generally resolves spontaneously without further complications or recurrence. That's the most important thing you need to know.

Complications as I described above can occur but are rare and managable (to an extent)

Vonnie · 4th June 2008, 9:52pm

The person has had these symptoms for a couple of weeks, I'm not sure if that still counts as getting treatment ASAP but Vicki I think you'll be familiar with who it is. The gist I'm getting from online sources is that it's not life threatening in the first instance but that it'll take a good while to recover from; it's at odds to what the medical team are saying about it so I'm trying to get a best and worst case scenario.

ETA my undertanding is that it is viral.

bikuki · 4th June 2008, 10:01pm

My sources (I've not seen this first hand) suggest that it'll take a few weeks for them to recover. How're they doing just now? (I do know who it is, btw) I'm pretty sure that unless they had a tamponade they'll do fine without much treatment other than supportive and some steroids, and it'll follow a course much like any viral infection (feeling crappy for a few weeks then back to normal).

**LesMTS** · 4th June 2008, 10:04pm

Quote:

Originally Posted by Vonnie

The person has had these symptoms for a couple of weeks, I'm not sure if that still counts as getting treatment ASAP but Vicki I think you'll be familiar with who it is. The gist I'm getting from online sources is that it's not life threatening in the first instance but that it'll take a good while to recover from; it's at odds to what the medical team are saying about it so I'm trying to get a best and worst case scenario.

ETA my undertanding is that it is viral.

I think it's unlikely that the the medical team are willfully withholding information, they're probably telling you exactly what they know about this specific case. From what I've read it's not the kind of thing you can immediately make specific claims about and they have ethics to consider in making "educated guesses".
Then again, I'm not involved in clinical medicine and can't give a great deal of insight. I'm a wee bit useful at being able to locate resources on clinical shit and recognising whether they're reliable or not.

Vonnie · 4th June 2008, 10:09pm

Les it's not that I think they're withholding anything, I just think in that particular hospital the left hand doesn't know what the right hand is doing and we're getting snippets of information that may be pieces of the whole scenario but still not being told everything we need to know.

Vicki - I don't know what a tamponade is which suggests they haven't had that! Patient is beyond tired, can't get comfortable to sleep and is in enough pain to warrant pretty regular hits of morphine. Can't lie flat or the pain flares up and breathing is difficult. Extremely pale and lethargic, BP was 167/60-odd when I first arrived at the hospital and dropped to 106/60-odd by the time I left. O2 sats fell between 96-100 usually at the lower end of the scale but they hadn't done (or mentioned doing) arterial bloods. Resps were between 11-16 (I think?) and HR was irregular for the majority of the five hours I could see the monitor.

Pantgirl · 4th June 2008, 10:16pm

Cardiac tamponade is blood in the pericardium which compresses the heart. I think *squints to remember*

bikuki · 4th June 2008, 10:19pm

"I don't know what a tamponade is which suggests they haven't had that!"
It's a buildup of fluid around the heart making the heart have to work alot harder.

"Patient is beyond tired, can't get comfortable to sleep and is in enough pain to warrant pretty regular hits of morphine."
They're not well, and that's to be expected

"Can't lie flat or the pain flares up and breathing is difficult"
The heart's having to work extra hard which is completely normal and nothing to worry about.

"BP was 167/60-odd when I first arrived at the hospital and dropped to 106/60-odd by the time I left".
As I said, the heart's having to work really hard - now the inflammation's going down this will improve.

"O2 sats fell between 96-100 usually at the lower end of the scale but they hadn't done (or mentioned doing) arterial bloods. Resps were between 11-16 (I think?)"
These are pretty normal and nothing to worry about (Sats of 98% or above is completely healthy, and 96% is still nowhere near life threatening.) Resp rate is normal.

"and HR was irregular for the majority of the five hours I could see the monitor."
Completely understandable given the situation, and will resolve as the infection clears and the inflammation goes down by itself/with steroids.