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Pericarditis; bacterial Causes and Risks:
Bacterial infections are one cause of pericarditis . Since the advent of antibiotics, bacterial pericarditis has become relatively rare, affecting approximately 1 out of 10,000 people. It most often occurs in men between the ages of 20 and 50, most frequently after some type of respiratory infection.
The bacterial infection causes inflammation and swelling of the pericardium. Pain occurs as a result of the inflamed pericardium rubbing against the heart. Fluid may accumulate in the pericardial sac.
The infection may occur because of spread of bacteria from an infection in the lung (such as pneumonia ), bacteremia (bacteria in the bloodstream), or after heart surgery.
The most common organisms are staphylococci, streptococci, pneumococci, hemophilus influenza (also called H.flu), and meningococci.
Prevention:
Bacterial pericarditis in many cases is not preventable. Treat respiratory infections and other disorders promptly.
Symptoms:
Signs and Tests:
When listening to the heart through a stethoscope ( auscultation ), the health care provider can hear a pericardial rubbing sound and heart sounds may be faint or distant. There may be other signs of fluid in the pericardium ( pericardial effusion ). If the disorder is severe, there may be signs of fluid in the space around the lungs ( pleural effusion ), such as decreased breath sounds . The person may appear toxic ( septic shock ) and critically ill. There may be signs of associated pneumonia .
Fluid around the heart may show on: The source of infection may be indicated by:
Treatment:
The goal of treatment is to improve heart function.
Antibiotics are used aggressively to treat bacterial infections. Other medications may include analgesics to relieve pain and diuretics to remove excess fluid. Aspirin, nonsteroidal anti-inflammatory medications (NSAIDS), or corticosteroids may be prescribed to relieve inflammation of the pericardium.
Bedrest with the head of the bed elevated may be recommended to reduce the workload on the heart.
Pericardiocentesis (removal of fluid from the pericardial sac) may be recommended to drain infected pericardial fluid; or to prevent or treat cardiac tamponade . Surgical pericardiectomy (cutting or removal of part of the pericardium) may be recommended if bacterial pericarditis is chronic or recurrent.
Prognosis:
The disorder may be life threatening if untreated. The outcome is good if bacterial pericarditis is treated promptly. Most people recover completely with treatment.
Complications:
Call Your Healthcare Provider:
Call your health care provider if symptoms indicate bacterial pericarditis may be present.
This is a cross-sectional view of the interior of the heart. The valves, chambers, and associated vessels are labeled.
This is an illustration of the exterior of the heart. The arteries are colored blue and represent blood that is flowing into the heart. The veins are red and indicate blood flow out from the heart. The chambers are also labeled.
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