Constrictive Pericarditis

[amsccs0992]

My husband was diagnosed with constrictive pericarditis this week.  This all started from a case of strep throat back in Feb.  He was treated with anti-biotics but kept complaining of chest pain.  He said it felt like pneumonia.  He was told he didn't have pneumonia after 2 x-rays - then a trip to the ER resulted in a diagnosis of pneumonia.  He was treated again with another antibiotic - 3 days later he had to be hospitalized - symptoms had worsened.  

While in-patient, he appeared to be improving after 2 days.  Day 3 he worsened.  This was consistent with the experience from the prior 2 rounds of antibiotics.  Finally, we convinced his attending that there was something going on besides pneumonia.  

A CAT scan was orderd.  When "something" looked strange, cardiology was called in.  After an echo-they said he had pericarditis - that was in March.  They prescribed an anti-inflammatory and he was released.  

At his follow up visit 2 weeks later, he complained of ongoing pain.  The cardiologist said he needed to give it more time.  It was a 10 minute visit.  My husband left the appt very frustrated.

He developed swelling in his legs and lower abdomen.  A new echo says it is now constrictive pericarditis.  They switched him off of the anti-inflammatory and prescribed colchicine for the first time in addition to a diuretic and high doses of aspirin.

My question - once pericarditis escalates to constrictive pericarditis, what is the prognosis?  I've read about the surgery.  Sounds like a last resort.

I need to understand what to expect from his treatment and if there are any alernate treatments that can be pursued.

The diuretics help a great deal but by evening, he is experiencing discomfort in his lower abdomen which is distended and clearly filled with fluid.

Please help me understand what we can do to help him.

Any alternate treatments or anyone with similar experiences?  

I am really frightened for him.

Thanks,
Ann Marie

[gmachris518]

Among my multitude of health problems, I get an occassional gout attack, caused by renal failure.  The drug of choice during an accute gout attack is colchicine, and it, by itself, is the worst medication I have in my huge collection.

I feel so bad for your husband.  He has all the symptoms asscociated with heart problems, and has to take colchicine on top of it.  Then they have him on high doses of Aspirin also.  My advice is to take note of his stool, when he has a bowel movement, and keep an eye open for black, sticky, diarreaha.  If it develops, get him back to the doctor ASAP, because it could be a bleeding ulcer.

I almost lost my life to a bleeding ulcer about 3 years ago.  By the time I made to the ER I was down 50% on my blood volume, and my body was trying to shut down.  I received 7 pints of blood to get me going again, and the human body only holds about 8, so a bleeding ulcer is nothing to mess around with.

[amsccs0992]

Thanks for responding.  I am looking into other cardiologists.  In my research I have found that colchicine is the recommended drug for treating pericardits as it does treat the inflammation.

I will definitely check into CHF and Coreg.  

Thanks for the info.

Ann Marie

[gmachris518]

I would be seeking out a second opinion.

Your husband's symptoms sound suspiciously close to CHF(congestive heart failure), and Lasix is a great med for it, but he also needs something to help his heart beat a bit better, and thus do a better job of pumping the fluid out of his lower extremities.  Coreg is the drug of choice for CHF, along with lasix, and a few others.  A "good" Cardiologist would know what to give him.  I've never heard of giving Colchicine for heart problems, as it is usually used for Gout, and causes terrible bouts of diarreaha.

It's very frightening when you know there is something wrong and none of the doctors will listen to you.  You NEED to find a doctor who will do something besides making him feel worse, by giving him meds that can cause terrible bouts of diarreaha, and bleeding ulcers.

Colchicine is usually prescribed for accute gout attacks.  Taken for gout, it clears the uric acid from the system.  By itself, it can cause terrible stomach pain, cramps, and diarreaha.

Aspirin, by itself, can cause terrible upper GI discomfort and and bleeding ulcers.

I hope the best for you and your husband, and I think if you find another doctor, you might get somewhere with his treatment.