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Treatments and drugs
By Mayo Clinic staffYour 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.
Rest and medications
Your doctor may recommend bed rest until you're feeling better. Medications to reduce the inflammation and swelling associated with pericarditis are often prescribed, including:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Most pain associated with pericarditis responds well to treatment with aspirin or another NSAID.
- Narcotic pain relievers. If your pain is severe, you might need stronger pain medications, such as morphine, for a short time.
- Colchicine. This drug, which reduces inflammation in the body, may be prescribed as a first line treatment for pericarditis or as a treatment for recurrent symptoms. Colchicine can reduce the length of pericarditis symptoms and decreases 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. Your doctor will carefully check your health history before prescribing colchicine.
- Corticosteroids. If you don't respond to NSAIDs 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. About one in five people with pericarditis has 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 undergo a technique called pericardiocentesis. In some cases of severe, recurrent pericarditis, your doctor might suggest surgically removing your pericardium (pericardiectomy).
- 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 compromising the functioning of your heart.
- Pericardium and pericarditis. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4683. Accessed March 12, 2009.
- Pericarditis. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec07/ch078/ch078a.html. Accessed March 12, 2009.
- Imazio M. Evaluation and management of acute pericarditis. http://www.uptodate.com/home/index.html. Accessed March 12, 2009.
- Ferri F. Pericarditis. In: Ferri FF. Ferri's Clinical Advisor 2009. St. Louis, Mo.: Mosby; 2008. http://www.mdconsult.com/das/book/body/128105427-3/821326688/1701/439.html#4-u1.0-B978-0-323-04134-8..50019-7--subchapter19_9365. Accessed March 12, 2009.
- Acute pericarditis. In: Libby P, et al, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/book/player/book.do?method=display&type=aboutPage&decorator=header&eid=4-u1.0-B978-1-4160-4106-1..X5001-8--TOP&isbn=978-1-4160-4106-1&uniq=125954092#lpState=open&lpTab=contentsTab&content=4-u1.0-B978-1-4160-4106-1..50073-X--cesec3%3Bfrom%3Dindex%3Btype%3DbookPage%3Bisbn%3D978-1-4160-4106-1. Accessed March 12, 2009.
