Therapy

Pericarditis is primarily treated symptomatically, i.e. an attempt is made to relieve the pain. For this purpose, painkillers from the group of so-called NSAIDs (non-steroidal anti-inflammatory drugs) are usually used. This group includes well-known painkillers such as ibuprofen or diclofenac.

In addition to having a pain-relieving effect, they also have an anti-inflammatory effect.Especially in cases of so-called idiopathic inflammation, an inflammation where the cause is unknown, this is usually the therapy of choice. In addition, colchicine (a component of the Autumn Timeless) is often prescribed, as it has an anti-inflammatory effect on inflammation of serous membranes such as the pericardium. Since studies have shown that recurrences are less frequent with colchicine therapy, it is particularly useful in cases of recurrent pericardial inflammation.

In rare cases, especially in cases of proven autoimmune disease, cortisone is also used to treat the inflammation. If a viral cause is determined as the trigger, cortisone must not be used for therapy, as the risk of recurrence is then increased. If an anti-inflammatory therapy is not sufficient, sometimes hospital treatment may be necessary.

If a bacterial pathogen is known as the trigger of pericarditis, it can be treated with antibiotics. In order to prevent the development of pericardial tamponade, a puncture must be made if there is a large accumulation of fluid. A special long needle is used to puncture the pericardium.

Small fluid accumulations of 10 to 50 ml, which are typical for a wet pericardial inflammation, do not require a puncture. If another disease, such as rheumatic disease or tumor disease, is responsible for the development of pericarditis, treatment of the underlying disease also simultaneously treats the pericarditis. An operation in the context of pericarditis becomes necessary when calcified and scarred pericarditis occurs.

This usually occurs as part of a chronic inflammation, in which the pericardium hardens. The hardening causes the heart to lose the elasticity it needs for its pumping function, which is impaired accordingly. As a result, the blood is backed up in the body’s circulation and symptoms of heart failure occur.

In this case, a surgeon may attempt to remove the calcific mantle or scarring through surgery. The operation can usually be performed without the use of a heart–lung machine. Such an operation is rarely necessary, but should not be performed too late to avoid the consequences of permanent heart strain.