Mr. Smith, a 33-year-old man, has been feeling very uncomfortable in his chest recently. He feels a dull pain when walking, sleeping, or taking deep breaths. The chest pain is only slightly relieved when he sits or leans forward. Mr. Smith thought it was due to being too tired from work, but one night he suddenly experienced severe pain in his chest, severe night sweats, and difficulty breathing. After being rushed to the hospital, the cause was discovered to be “pericarditis.”

Mr. Smith was very puzzled. He thought he lived a normal life, so why did he suffer from pericarditis? What exactly is pericarditis? Why do young people also get sick? We will reveal the causes of pericarditis, symptoms and treatment of pericarditis for you, so that pericarditis will no longer sneak up on you.

What is pericarditis?

The pericardium is a layer of membranous tissue covering the outside of the heart. It is divided into inner and outer layers. There is about 20~30ml of pericardial fluid between the two layers, which is used for buffering and lubrication, and can protect the heart from impact or friction. When the pericardium is infected by bacteria, viruses, or becomes inflamed due to an autoimmune disease, it is called pericarditis, also known as “pericarditis.” It is more common in men or young adults.

2 major causes of pericarditis

The causes of pericarditis are divided into two categories: “infectious” and “non-infectious”. Infectious causes are mainly caused by viral or bacterial infections. In developed countries such as Taiwan, viral infections are the most common. For example, the aforementioned case of Mr. Wang is one of the common infections. In developing countries, mycobacterium tuberculosis infection is the most common infection. (Tuberculosis, TB) mainly.

Non-infectious causes are mostly caused by the patient’s own chronic diseases or drug-induced infection. Infectious and non-infectious causes are further subdivided as follows:

Infectious causes

1. Viral infection: Coxsackie Viruses type B (a type of enterovirus), Adenovirus
   
2. Bacterial infection: Mycobacterium tuberculosis, pyogenic bacteria

Non-infectious causes

1. Autoimmune diseases: lupus erythematosus, rheumatic fever
   
2. Uremia
   
3. Drug-induced infections: mRNA vaccine, Procainamide, Isoniazid, Hydralazine, Phenytoin, Penicillin, Doxorubicin

Pericarditis symptoms

Pericarditis can be divided into two types: “acute pericarditis” and “chronic pericarditis”, but acute pericarditis is the most common clinically. Patients should seek medical treatment as soon as possible when they experience severe chest pain.

1. Acute pericarditis:
   Symptoms last less than 3 weeks. Severe pain in the center of the chest that worsens with deep breathing. The patient is feverish and weak, and may have trouble breathing, palpitations, cough, or fever. A small number of patients develop hydropericardium and pericardial tamponade. If blood circulation is affected, fluid extraction treatment is required.
   
2. Chronic pericarditis:
   Symptoms persist for more than 3 months. Patients are in a state of fatigue for a long time and have symptoms such as coughing, shortness of breath, low blood pressure, or swelling of the legs and stomach. Chronic pericarditis can easily cause pericardial hydrops, which can compress the heart and lead to heart failure. Immediate treatment is required to avoid sudden death from shock.

Why is it more uncomfortable to lie down or take deep breaths with pericarditis?

When the patient takes a deep breath or lies down, the heart and pericardium will be closer, causing friction and discomfort; conversely, when sitting or leaning the upper body forward, the gap between the heart and the pericardium will increase, reducing friction caused by friction. Severe pain.

How is pericarditis treated?

Most doctors will first improve the anti-inflammatory situation by prescribing aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) plus colchicine, and prescribe appropriate medicine according to the patient’s condition. For example, patients with tuberculosis are treated with antibiotics; those with autoimmune diseases are treated with steroids, analgesics and antipyretics.

But when the patient has severe hydropericardium, the doctor will arrange for a pericardiectomy to remove the hydropericardium to reduce the pressure on the heart.

Most patients will improve significantly after a few weeks of treatment, but patients need to pay attention to wheezing or other complications. If new symptoms appear, you should seek medical examination quickly to avoid misjudgment of the condition and delay in seeking medical treatment, which may lead to more serious heart problems.