Pericarditis: diagnosis and treatment

Pericarditis: diagnosis and treatment

The diagnosis of pericarditis is derived from the description of the symptoms and the examination of the heart. Before starting treatment, it should be clarified whether the pericarditis is due to an unknown cause or whether another disease triggers the inflammation of the pericardium. If this is the case, the cause must be treated to prevent the progression of the pericarditis.

Pericarditis Diagnostics

The diagnosis of pericarditis is based on the symptoms and the examination findings. A rubbing noise is typical when listening, but this often disappears as soon as an effusion forms.

Chest X-rays, electrocardiograms (ECGs) and heart ultrasounds are primarily used for diagnostic imaging. The advantage of ultrasound is that the accumulation of fluid in the pericardium and its effects on heart function can be shown directly.

To investigate the cause, liquid can be taken from the outflow and checked to see which cells are present: inflammatory cells, protein, blood components, or degenerated cells from cancerous tumours.


treatment of pericarditis

General measures alleviate the symptoms and eliminate the after-effects of the inflammation, such as the pericardial effusion.

If a cause is known, it is treated. For example, rheumatic fever is treated with antibiotics and cortisone, and the body’s defences are suppressed in the case of immune diseases. Kidney dysfunction, hypothyroidism or cancer are also treated with special measures.

Painkillers may be given for chest pain. In the case of a pronounced pericardial effusion, the excess fluid in the pericardial sac must be drained via a catheter inserted into the pericardial sac with a long needle from the front below the costal arch. In most cases of acute pericarditis, the inflammatory process heals without consequences after one or more fluid drainages.

Surgery is rarely necessary.

Only in the rare case of chronic, recurring pericardial effusions does the pericardial sac have to be surgically “fenestrated” to allow the inflammatory fluid to drain away on its own.

A heart surgeon must remove the pericardial scarring in the rare armoured heart.

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