Your treatment choice for pericarditis depends on the cause as well as the severity. Mild cases of pericarditis may get better on their own without treatment.
Medications to reduce the inflammation and swelling associated with pericarditis are often prescribed, including:
- Over-the-counter pain relievers. Most pain associated with pericarditis responds well to treatment with pain relievers available without a prescription, such as aspirin or ibuprofen (Advil, Motrin others).
- Narcotic pain relievers. If your pain is severe, you might need stronger pain medications, such as morphine, for a short time.
- Colchicine (Colcrys). This drug, which reduces inflammation in the body, may be prescribed for pericarditis or as a treatment for recurrent symptoms. Colchicine can reduce the length of pericarditis symptoms and decrease the risk that the condition will recur. However, the drug is not safe for people with certain pre-existing health problems, such as liver or kidney disease, and for those taking certain medications. Your doctor will carefully check your health history before prescribing colchicine.
- Corticosteroids. If you don't respond to pain relievers or colchicine or if you have recurrent symptoms of pericarditis, your doctor may prescribe a steroid medication, such as prednisone.
Acute episodes of pericarditis typically last from one to three weeks, but future episodes can occur. Some people with pericarditis have a recurrence within months of the original episode.
When a bacterial infection is the underlying cause of pericarditis, you'll be treated with antibiotics and drainage if necessary.
Hospitalization and procedures
You'll likely need hospitalization if your doctor suspects cardiac tamponade, a dangerous complication of pericarditis due to fluid buildup around the heart. When cardiac tamponade is present, you may need a procedure called pericardiocentesis. In some cases of severe, recurrent pericarditis, your doctor might suggest surgically removing your pericardium (pericardiectomy).
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- Pericardiocentesis. In this procedure, a doctor uses a sterile needle or a small tube (catheter) to remove and drain the excess fluid from the pericardial cavity. You'll receive a local anesthetic before undergoing pericardiocentesis, which is often done with echocardiogram monitoring and ultrasound guidance. This drainage may continue for several days during the course of your hospitalization.
- Pericardiectomy. If you're diagnosed with constrictive pericarditis, you may need to undergo a surgical procedure (pericardiectomy) to remove the entire pericardium that has become rigid and is making it hard for your heart to pump.
- Cohen S, et al. Pericarditis. In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05610-6..00025-1--sc30620&isbn=978-0-323-05610-6&type=bookPage§ionEid=4-u1.0-B978-0-323-05610-6..00025-1--sc30620&uniqId=234882123-3. Accessed Feb. 8, 2011.
- Pericarditis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/sec07/ch078/ch078a.html. Accessed Feb. 8, 2011.
- Pericardium and Pericarditis. American Heart Association. http://www.americanheart.org/print_presenter.jhtml?identifier=4683. Accessed Feb. 8, 2011.
- Imazio M. Evaluation and management of acute pericarditis. http://www.uptodate.com/home/index.html. Accessed Feb. 8, 2011.
- Grogan M (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 18, 2011.