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Care During Chemotherapy and Beyond

Pericarditis

What Is Pericarditis?

Pericarditis is an inflammation (redness and swelling) of the thin, protective membrane that surrounds the heart, and keeps it in its proper anatomic location. The thin, loose tissue will allow the heart to change in size, and move with each heartbeat. Inflammation of this membrane may cause chest pain.

Causes of Pericarditis Include:

  • Infection - From a bacteria or a virus, which causes inflammation; rheumatic fever, or tuberculosis
  • Cancers - causing inflammation of the pericardium from spreading of lung, breast, renal cell cancer; Hodgkin's disease, and lymphoma
  • Certain Immune diseases - such as Systemic Lupus Erythematosus (SLE, or Lupus) can cause pericarditis
  • Injury to the heart muscle - from radiation therapy to the chest area, drugs, or a heart attack (myocardial infarction) - can cause pericarditis
  • Sometimes the cause is unknown

Symptoms of Pericarditis:

  • Chest pain is most often sharp or burning in character
  • Pain may start in the chest, and spread to the throat, jaw, shoulder blades, or arms (left or right). However, you may feel symptoms of palpitations instead of pain.
  • You may experience a feeling of chest heaviness, or tightness. There may be increased pain when you take a deep breath, or change positions (especially when you lean forward).
  • You may have nausea, sweating, or dizziness associated with your chest pain. It may also cause you to feel short of breath. Your chest pain may spread to the stomach, and feel like indigestion.
  • Some people may feel terribly excruciating chest pain, and others may experience a mild discomfort. The severity of the symptom does not indicate how severe the damage to the heart muscle may be.
  • Pericarditis may cause you to be overly tired, or very weak (fatigued). It may be hard for you to do any kind of your normal activities.
  • You may experience sudden or gradual shortness of breath, either at rest or while performing any type of activity. This may include walking to the door, or climbing stairs.

Things You Can Do About Pericarditis:

  • The goal of treating pericarditis is to identify and treat the cause of your symptoms. If pericarditis is due to a bacterial infection, you will most likely receive intravenous (IV) antibiotics in the hospital. Non-steroidal Anti-Inflammatory (NSAIDS) medications, or aspirin, will likely be given to decrease the inflammation of the lining of your heart, and provide comfort. 
  • If you smoke, be sure to quit. Smoking can increase the chance of developing chest pain and heart disease.
  • Make sure to exercise, under the supervision of your healthcare provider. Walking, swimming, or light aerobic activity may help you to promote the flow of oxygen in your lungs and blood, thus reducing your symptoms. Discuss with your healthcare provider how you can maintain your optimal level of functioning during this illness.
  • Eat a well -balanced meal, limiting salt intake, high fat and high cholesterol foods.
  • Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies).  Do not take aspirin or products containing aspirin unless your healthcare provider permits this.
  • Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease.
  • Notify your healthcare provider if you have a family history of heart disease, stroke, high blood cholesterol, or high blood pressure, in a first or second-degree relative.
  • If you are ordered a medication to treat your pericarditis, do not stop taking any medication unless your healthcare provider tells you to. Take the medication exactly as directed. Do not share your pills with anyone.
  • If you miss a dose of your pericarditis medication, discuss with your healthcare provider what you should do.
  • Use relaxation techniques to decrease the amount of anxiety you have. If you feel anxious, place yourself in a quiet environment, and close your eyes. Take slow, steady, deep breaths, and try to concentrate on things that have relaxed you in the past. Such techniques may lessen symptoms of pericarditis.
  • If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team.  They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
  • Keep all your appointments for your treatments.

Drugs That May Be Prescribed by Your Doctor:

Your doctor or healthcare provider may prescribe certain drugs to help your heart muscle work more effectively, or to control your symptoms of pericarditis. These may include:

  • ACE inhibitors - These drugs work by opening, or dilating, your arteries. They will lower your blood pressure, and improve blood flow to your kidneys, and through out your body, thus lessening your symptoms. Your healthcare provider may also prescribe these medications if you have diabetes or protein in your urine, to protect your kidneys. Some examples of this medication may include: enalapril maleate (Vasotec®), lisinopril (Zestril®), and fosinopril sodium (Monopril®)
  • Antibiotics - If your doctor or healthcare provider suspects that a bacterial infection has caused your pericarditis (not a viral), he or she may order antibiotics, usually intravenous (IV). If you are prescribed antibiotics, you may need to be admitted to the hospital unit for evaluation.
  • Antianxiety medications: If you have symptoms of anxiety, which might be aggravated by your symptoms of pericarditis, your healthcare provider may prescribe an Anti-anxiety medication, called an anxiolytic.  These medications will help you to relax. These may include lorazepam (Ativan®), or alprazolam (Xanax®).  It is important to take these medications only when you are feeling anxious. Do not operate heavy machinery, or drive an automobile while taking these. If these medications do not control your symptoms, discuss this with your doctor.
  • Aspirin - Depending on your overall health status, your healthcare provider may prescribe aspirin as a "blood thinner", or to relieve your pericarditis. Aspirin works by preventing platelets in your blood from forming blood clots (anti-platelet).
  • Beta-blockers - can be used to slow down your heart rate, and improve blood flow through your body, thus lessen symptoms of pericarditis. You may take this drug if you have been diagnosed with irregular heartbeats, or high blood pressure. Some examples of this medication may include: Metoprolol (Lopressor®), propranolol (Inderal®), and atenolol (Tenormin®).
  • Calcium Channel Blockers - These medications may be given to treat chest pain, high blood pressure, or irregular heart beats. A few common drugs include verapamil HCL (Calan®), and diltiazem (Dilacor XR®).
  • Nitrates - such as nitroglycerin, work to increase blood flow to the heart. They also decrease the work of the heart by dilating (expanding) the arteries, thus lessening your symptoms. You may take this during an episode of chest pain, if your doctor has determined that it is safe. 
  • Non-steroidal anti-inflammatory (NSAID) agents - Such as naproxen sodium and ibuprofen may provide relief of pain. If you are to avoid NSAID drugs, because of your type of cancer or chemotherapy you are receiving, acetaminophen (Tylenol®) up to 4000 mg per day (two extra-strength tablets every 6 hours) may help. It is important not to exceed the recommended daily dose of Tylenol®, as it may cause liver damage. Discuss this with your healthcare provider.
  • Do not stop any of these medications abruptly, as serious side effects may occur

When to Contact Your Doctor or Health Care Provider:

Call your doctor with the following symptoms:

  • Fever of 100.5° F (38° C), chills, sore throat (possible signs of infection).
  • Sudden or gradual shortness of breath, chest pain or discomfort; swelling of your lips or throat should be evaluated immediately
  • Feel your heart beat rapidly (palpitations), and have not noticed this before
  • Any new rashes on your skin, especially if you have recently changed medications
  • Any unusual swelling in your feet and legs, or weight gain of greater than 3 to 5 pounds in 1 week.

Note:  We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.

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