Treatment

Treatment for pericarditis depends on the cause as well as the severity. Mild cases of pericarditis may get better on their own without treatment.

Medications

Medications to reduce the inflammation and swelling associated with pericarditis are often prescribed, including:

  • 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 IB, others). These medications also help lessen inflammation. Prescription-strength pain relievers also may be used.
  • Colchicine (Colcrys, Mitigare). This drug, which reduces inflammation in the body, may be prescribed for acute 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 a few weeks, but future episodes can occur. Some people with pericarditis have a recurrence within months after 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.

If cardiac tamponade is present, your doctor may recommend a procedure to relieve fluid buildup, such as:

  • 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.
June 16, 2017
References
  1. Ferri FF. Pericarditis. In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Feb. 14, 2017.
  2. Bennett JE, et al., eds. Myocarditis and pericarditis. In: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2015. https://www.clinicalkey.com. Accessed Feb. 14, 2017.
  3. Imazio M, et al. Evaluation and treatment of pericarditis: A systematic review. JAMA. 2015;314:1498.
  4. What is pericarditis? American Heart Association. http://www.heart.org/HEARTORG/Conditions/More/What-is-Pericarditis_UCM_444931_Article.jsp. Accessed Feb. 14, 2017.
  5. What is pericarditis? National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/health-topics/topics/peri/#. Accessed Feb. 16, 2017.
  6. Imazio M, et al. Recurrent pericarditis. La Revue de Médecine Interne. In press. Accessed Feb. 14, 2017.
  7. Imazio M, et al. Recurrent pericarditis: Modern approach in 2016. Current Cardiology Reports. 2016;18:50.
  8. Raval J, et al. The role of colchicine in pericarditis: A systematic review and meta-analysis of randomised trials. Heart, Lung and Circulation. 2015;24:660.
  9. Riggin EA. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Feb. 16, 2017.
  10. Riggin EA. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Jan. 10, 2017.
  11. Lopez-Jimenez F (expert opinion). Mayo Clinic, Rochester, Minn. March 1, 2017.

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