Treatments for Pericarditis

Treatments of Pericarditis: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the treatments of Pericarditis.

Endocarditis: Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))

Antimicrobials, supportive care (nutritional therapy, antipyretics, sufficient fluid intake)

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Myocarditis: Treatment
(Professional Guide to Diseases (Eighth Edition))

Treatment includes antibiotics for bacterial infection, modified bed rest to decrease heart workload, and careful management of complications. Inotropic support of cardiac function with amrinone, dopamine, or dobutamine may be needed. Heart failure requires restriction of activity to minimize myocardial oxygen consumption, supplemental oxygen therapy, sodium restriction, diuretics to decrease fluid retention, and cardiac glycosides to increase myocardial contractility. However, cardiac glycosides should be administered cautiously because some patients with myocarditis may show a paradoxical sensitivity to even small doses. Arrhythmias necessitate prompt but cautious administration of antiarrhythmics because these drugs depress myocardial contractility. Thromboembolism requires anticoagulation therapy. Treatment with corticosteroids or other immunosuppressants may be used to reduce inflammation, but they haven’t been shown to change the progression of myocarditis infections. Nonsteroidal anti-inflammatory drugs are contraindicated during the acute phase (first 2 weeks) because they increase myocardial damage.

Surgical treatment may include left ventricular assistive devices and extra corporeal membrane oxygenation for support of cardiogenic shock. Cardiac transplantation has been beneficial for giant cell myocarditis.

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Pericarditis: Treatment
(Professional Guide to Diseases (Eighth Edition))

The goal of treatment is to relieve symptoms and manage the underlying systemic disease. In acute idiopathic pericarditis and postthoracotomy pericarditis, treatment consists of bed rest as long as fever and pain persist, and nonsteroidal drugs, such as aspirin and indomethacin, to relieve pain and reduce inflammation. Post-MI patients should avoid nonsteroidal anti-inflammatory drugs and steroids because they may interfere with myocardial scar formation. If these drugs fail to relieve symptoms, corticosteroids may be used. Although corticosteroids produce rapid and effective relief, they must be used cautiously because episodes may recur when therapy is discontinued.

Infectious pericarditis that results from disease of the left pleural space, mediastinal abscesses, or septicemia requires antibiotics (possibly by direct pericardial injection), surgical drainage, or both. Cardiac tamponade may require pericardiocentesis. Signs of tamponade include pulsus paradoxus, jugular vein distention, dyspnea, and shock.

Recurrent pericarditis may necessitate partial pericardectomy, which creates a “window’’ that allows fluid to drain into the pleural space. In constrictive pericarditis, total pericardectomy to permit adequate filling and contraction of the heart may be necessary. Treatment must also include management of rheumatic fever, uremia, tuberculosis, and other underlying disorders.

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Endocarditis: Treatment
(Handbook of Diseases)

The goal of treatment is to eradicate the infecting organism. Antimicrobial therapy should start promptly and continue over 4 to 6 weeks. Selection of an antibiotic is based on identification of the infecting organism and on sensitivity studies. While awaiting test results or if blood cultures are negative, empiric antimicrobial therapy is based on the likely infecting organism.

Supportive treatment includes bed rest, aspirin for fever and aches, and sufficient fluid intake. Severe valvular damage, especially aortic or mitral insufficiency, may necessitate corrective surgery if refractory heart failure develops or in cases in which an infected prosthetic valve must be replaced.

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Myocarditis: Treatment
(Handbook of Diseases)

Treatment includes an antibiotic for bacterial infection, modified bed rest to decrease the cardiac workload, and careful management of complications. Heart failure requires restriction of activity to minimize myocardial oxygen consumption, supplemental oxygen therapy, sodium restriction, a diuretic to decrease fluid retention, and a cardiac glycoside to increase myocardial contractility. However, cardiac glycosides must be administered cautiously because some patients with myocarditis show a paradoxical sensitivity to even small doses.

Arrhythmias necessitate prompt but cautious administration of antiarrhythmics, which can depress myocardial contractility. Thromboembolism requires anticoagulation therapy. Treatment with a corticosteroid or other immunosuppressant is controversial and therefore limited to combating life-threatening complications such as intractable heart failure.

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Pericarditis: Treatment
(Handbook of Diseases)

The goal of treatment is to relieve symptoms and manage underlying systemic disease.

Bed rest and drug therapy

With acute idiopathic pericarditis, post-MI pericarditis, and postthoracotomy pericarditis, treatment consists of bed rest while fever and pain persist and nonsteroidal anti-inflammatory drugs, such as aspirin and indomethacin, to relieve pain and reduce inflammation.

If these drugs fail to relieve symptoms, corticosteroids may be used. Although corticosteroids produce rapid and effective relief, they must be used cautiously because episodes may recur when therapy is discontinued.

Infectious pericarditis that results from disease of the left pleural space, mediastinal abscesses, or septicemia requires antibiotics (possibly by direct pericardial injection), surgical drainage, or both. Cardiac tamponade may require pericardiocentesis. Signs of tamponade include paradoxical pulse, jugular vein distention, dyspnea, and shock.

Pericardectomy

Recurrent pericarditis may necessitate a partial pericardectomy, which creates a “window” that allows fluid to drain into the pleural space. In constrictive pericarditis, a total pericardectomy to permit adequate filling and contraction of the heart may be necessary. Treatment must also include management of rheumatic fever, uremia, tuberculosis, and other underlying disorders.

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Pericardial friction rub: Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Explain the underlying disorder and its treatments to the patient. Encourage the patient to sit upright to relieve dyspnea and chest pain. To promote comfort and ease anxiety, reassure the patient with acute pericarditis that his condition is temporary.

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Pericardial friction rub: Nursing considerations
(Nursing: Interpreting Signs and Symptoms)

▪ Monitor the patient's cardiovascular status and cardiac rhythm.

▪ If the pericardial friction rub disappears, be alert for signs of cardiac tamponade.

▪ If the patient develops cardiac tamponade, prepare him for pericardiocentesis to prevent cardiovascular collapse.

▪ Ensure that the patient gets adequate rest.

▪ Give an anti-inflammatory, antiarrhythmic, diuretic, or antimicrobial to treat the underlying cause.

▪ If necessary, prepare him for a pericardiectomy to promote adequate cardiac filling and contraction.

Patient teaching

▪ Teach the patient about the disorder and treatment plan.

▪ Teach about prescribed medications, including their dosage, administration, and adverse effects.

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Medical news summaries about treatments for Pericarditis:

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