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Cardiolucent

Condition

Pericarditis

Anti-inflammatory therapy and recurrence prevention for pericardial inflammation.

Pericarditis is inflammation of the pericardium, the fibrous sac that surrounds the heart. It typically presents with sharp chest pain that is worse with lying flat or deep breathing and improved by sitting up and leaning forward. Most cases are viral or post-viral, though autoimmune disease, prior cardiac surgery or myocardial infarction, kidney disease, and medications can also be responsible. The acute illness is usually self-limited with appropriate treatment, but recurrence is a recognized complication, sometimes leading to chronic or constrictive pericarditis. Modern management with NSAIDs and colchicine has dramatically reduced recurrence rates. Dr. Kedan manages acute pericarditis with attention to ruling out worrisome features and works to prevent the recurrent disease that can complicate this otherwise benign condition.

What Cardiolucent Evaluates

  • Characteristic history of pleuritic, position-dependent chest pain
  • EKG for typical diffuse ST elevation and PR depression
  • POCUS and formal echocardiography to assess for pericardial effusion
  • Inflammatory markers (CRP, ESR) and troponin to look for myocardial involvement
  • Workup for underlying cause when suggestive features are present
  • Anti-inflammatory regimen (NSAIDs and colchicine) with personalized duration
  • Surveillance for recurrence and constriction

Common Symptoms

  • Sharp chest pain worse with deep breathing or lying flat
  • Pain that improves with sitting up and leaning forward
  • Low-grade fever and malaise
  • Pericardial friction rub on examination
  • Shortness of breath, particularly if pericardial effusion is present
  • Symptoms often preceded by a viral upper respiratory illness

Risk Factors

  • Recent viral infection
  • Autoimmune or systemic inflammatory diseases (lupus, rheumatoid arthritis)
  • Prior heart attack (post-MI pericarditis)
  • Prior cardiac surgery (post-pericardiotomy syndrome)
  • Kidney failure (uremic pericarditis)
  • Certain medications
  • Tuberculosis and other infections (uncommon in developed settings)
  • Prior episode of pericarditis

How Cardiolucent Approaches Treatment

The cornerstone is NSAIDs (typically ibuprofen or naproxen) plus colchicine, which together provide effective symptom control and substantially reduce recurrence risk. The duration of colchicine is at least three months for a first episode and longer for recurrent disease. Corticosteroids are reserved for specific situations because they increase recurrence risk. Dr. Kedan tailors the regimen to your specific case, monitors response, and screens for the rare complications of constrictive pericarditis and chronic effusion. When recurrent or refractory disease develops, coordination with rheumatology and pericardial disease specialists at Cedars-Sinai is part of the plan.

Common Questions

Frequently Asked Questions

What is pericarditis?
Pericarditis is inflammation of the pericardium, the sac around the heart. The characteristic symptom is sharp chest pain that is worse with breathing or lying flat and better when sitting forward.
How is it diagnosed?
Diagnosis combines the clinical history with characteristic EKG changes (diffuse ST elevation with PR depression), inflammatory markers, and echocardiography to assess for pericardial effusion. Cardiac MRI can be useful in ambiguous cases or when myocardial involvement is suspected.
Is pericarditis dangerous?
Most cases are self-limited and resolve fully with appropriate treatment. Complications — large pericardial effusion with cardiac tamponade, recurrent pericarditis, and rarely constrictive pericarditis — do occur and require timely recognition. Pericarditis with significant myocardial involvement (myopericarditis) has additional considerations.
What causes pericarditis?
Most cases are viral or post-viral and a specific virus is rarely identified. Other causes include autoimmune diseases, post-cardiac surgery or post-myocardial infarction reactions, kidney failure, certain medications, and uncommonly infections like tuberculosis. The cause is often presumed viral when no other explanation is found.
How is pericarditis treated?
The cornerstone is NSAIDs (typically ibuprofen or naproxen) plus colchicine. Colchicine is particularly important because it substantially reduces the risk of recurrence. The total duration of treatment is usually several months and is individualized based on response and recurrence history.
Why are steroids generally avoided?
Corticosteroids effectively relieve symptoms in pericarditis but are associated with higher rates of recurrence. They are reserved for specific situations, such as patients who cannot tolerate NSAIDs and colchicine or those with autoimmune-driven pericarditis under rheumatology guidance.
Can pericarditis recur?
Yes — recurrence is one of the most challenging aspects of pericarditis, affecting a meaningful proportion of patients. Colchicine has substantially reduced this risk. Multiple recurrences may require longer or modified therapy and specialist consultation.
Should I avoid exercise during recovery?
Yes. Strenuous exercise should be avoided until symptoms have resolved and inflammatory markers have normalized, typically several weeks to months depending on severity. This restriction is particularly important if there is any myocardial involvement. Dr. Kedan provides individualized guidance.
When is pericardial fluid drained?
Pericardial drainage (pericardiocentesis) is performed for large effusions causing hemodynamic compromise (tamponade) or for diagnostic purposes when the cause is unclear and a sample is needed. Most pericardial effusions do not require drainage.
How do I schedule a consultation?
Call (310) 304-5555 or use the contact form to schedule with Dr. Kedan at the Beverly Hills office. Cardiolucent does not bill Medicare or insurance; a detailed superbill is provided for any out-of-network reimbursement.

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Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.