Breathlessness after pericarditis

[aefaef]

Hi,

Some background: I am a 32 year old male, mild NASH (inflammation
level 1 on a scale of 1-6), enlarged spleen (14cm), expecting imminent
diagnosis of IGT or diabetes following high results from OGTT (fasting
levels normal). No history of asthma or breathing conditions, though I
occasionally wheezed a little when exterting myself when younger.
I've recently dropped from 306 lbs to 270 lbs in seven weeks following
first indications of diabetes (substantially different diet).

Went to A&E (ER) just over 2 weeks ago with tight chest pains. Normal
ECG, sent home. Returned in the evening as pain worsened. Diagnosed
pericarditis based on physical exam, ECG (not normal) and hand-held
ultrasound scan. Chest X-ray and blood tests for heart attack and
blood clots found no additional surprises. (BPs were normal(ish), I
think).

Pain dramatically improved over 24 hours - resolved in a couple of
days. But I still had periods of breathlessness at rest.

The nature of the breathlessness is that I can physically breathe with
no problems, but "feel" breathless, even if I breathe more
rapidly. Lips and fingernails normal, I can move about, etc. With
exertion, I don't seem to get significantly more breathlessness than I
normally would.  It often seems to come on in the evening and last
until around the middle of the next day. It doesn't seem to be related
to stress or panic.

On Tuesday, 2 weeks after the initial diagnosis, I had a follow-up at
the chest pain clinic. ECG, treadmill ECG, BPs all normal. They said
no further signs of pericarditis. Awaiting official results of
echocardiogram, but the operators indicated there wasn't anything
obviously wrong. As the breathlessness had been much better on the
previous day (Monday) I assumed this meant that I was recovered.

All was well until yesterday (Thursday) evening, when breathlessness
returned, lasting until around 2pm today. (My GP instructed me to
avoid exertion. I'd been a little more active yesterday - doing some
housework instead of sitting still.)

My main questions are: could this breathlessness have been caused by
the pericarditis and persist after the medical signs of pericarditis
have passed? If so, will it resolve on its own? Is it common for
breathlessness to persist, and for how long?

Any additional advice/ideas would be gratefully received. My GP isn't
sure what's going on, and has given me an asthma inhaler to try, to
see if it helps.

Many thanks, in advance, for any advice.

[babs275]

  I have had a few recurrent cases of pericarditis over the past 5 years.  I am a very fit 60 year old female with normal everything on cardiac workup.  I have found that when feeling breathless, if I take my pulse, it has gone up to double my resting pulse.  Like my normal is 60 or 70 and it goes up to 120.  Sometimes just going up 8 stairs is all it takes to do this.  Learn to take your pulse and see if this is you.  My cardiologist says one of her mentors said that tachycardia is one of the most common symptoms of pericarditis though you don't see it on the lists.  My episodes have only lasted a few days.  Long term prognosis is good.

[aefaef]

Thanks for your reply.

No diagnosed cause - most cases of pericarditis are idiopathic and the usual suspicion is a viral infection.

I'm getting spells of breathlessness at rest every three days or so, at the moment. Given that there were no further signs of pericarditis (or anything) at the last follow-up, I'd really like to know what's going-on with the breathlessness :(

I'd be really interested in other people's experience of breathlessness after pericarditis.

I've got another appointment with my GP on Thursday to re-evaluate, and he indicated he'll refer me to someone else if I'm still having symptoms.

[kenkeith]

Usually with pericarditis there is a fever.  Has the underlying cause for the pericardium inflammation been diagnosed?

What happens after treatment for the condition may depend on the underlying cause.
Most episodes of pericarditis after a heart attack resolve by themselves and need no further treatment. The focus is usually on treating the underlying heart disease. In some cases, treatment may be needed in the future for repeated episodes of pericarditis.

In most cases, this condition causes few or no long-term effects. In some people, this condition may come back several times with severe pain, but it usually responds to treatment each time.

The results of the echo is a good source to rule out pericarditis as it can view any abnormal effusion in the pericardial sac.  





How is the condition monitored?
If the symptoms go away, the only needed monitoring is for the underlying heart disease. Someone who has had a heart attack needs close monitoring and treatment to prevent a second heart attack. Any new or worsening symptoms should be reported to the healthcare provider.