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Heart Disease (Expert Forum)
Can pericarditis cause a diaphramatic hernia?
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Can pericarditis cause a diaphramatic hernia?
by Pat, Nov 14, 1999 12:00AM
I am a healthy 50-year old woman. Last fall, within a week of undergoing a root canal procedure with a new dentist, (my previous dentist had just retired) I developed severe chest pain accompanied by extreme anxiety and an inability to draw a complete breath. I finally went to an ER one night when it felt like I was about to pass out from lack of oxygen.
Even though I am normally a calm sort, I was so frightened that I was very anxious and wanted immediate attention. Despite the fact that I thought I might be having a heart attack, I was treated pretty cavlierly in the ER, given a low priority during triage, and left sitting in the waiting area.
When I was finally called in two hours later, they did an EKG and determined that my heart was fine, even though it was beating very fast, 220 beats per minute. (My normal resting heart rate is around 80 beats per minute.) They chalked the rapid heartbeat up to anxiety, and spent another two hours scratching their heads. Just when they were about to settle on a diagnosis of "hysterical woman," I mentioned the root canal. They sprang into action, did a blood test and a chest x-ray and announced that I had pericarditis. They gave me a prescription for antibiotics and sent me home, at three in the morning, deathly ill, probably because I do not have insurance. They did not request any follow-up visits.
I was very ill for almost three weeks, but have since recovered my health for the most part. I got on a walking program and have rebuilt my endurance. When I visited a cardiologist several months afterwards and described my symptoms and treatment, she was enraged when she heard I'd been sent home. When she looked at my discharge papers, (which I hadn't ever read) the diagnosis was "heart palpitations with anxiety" and no mention of the pericarditis they told me I had. She told me powerful antibiotics were not prescribed for heart palpitations, and questioned why there had been no follow-up recommendations for such a serious illness. When she contacted the attending doctor, he admitted that I had pericarditis, but could not explain why a different diagnois was put my discharge papers, or why I'd been sent home and not admitted to the hospital.
Here's my problem. Ever since the pericarditis, whenever I lie on my left side, it feels like I am lying on a rock, and that the rock is wedged right underneath the lowest rib on the left. Over the last few months, that uncomfortable feeling of something pinching or something not quite fitting in place has persisted and now affects me even when I am sitting up. There is no pain, only an truly uncomfortable feeling of pressure or fullness on that left side right under my last rib. When I press there, I can feel something hard that seems like it doesn't belong, and there is no similar area on my right side. Also, whenever I press the area, I get a strange sensation in my stomach and can actually hear and feel digestive juices sort of squishing along in there, but once again, no pain accompanies this, just a really weird sensation.
So, my question is this: can severe pericarditis produce enough pressure on the diaphram to cause a hernia, and are these symptoms consistent with a diagnosis of diaphramatic hernia? If so, what is the treatment I should seek, and which type of doctor should I see, a cardiologist or an internal medicine specialist?
Even though I am normally a calm sort, I was so frightened that I was very anxious and wanted immediate attention. Despite the fact that I thought I might be having a heart attack, I was treated pretty cavlierly in the ER, given a low priority during triage, and left sitting in the waiting area.
When I was finally called in two hours later, they did an EKG and determined that my heart was fine, even though it was beating very fast, 220 beats per minute. (My normal resting heart rate is around 80 beats per minute.) They chalked the rapid heartbeat up to anxiety, and spent another two hours scratching their heads. Just when they were about to settle on a diagnosis of "hysterical woman," I mentioned the root canal. They sprang into action, did a blood test and a chest x-ray and announced that I had pericarditis. They gave me a prescription for antibiotics and sent me home, at three in the morning, deathly ill, probably because I do not have insurance. They did not request any follow-up visits.
I was very ill for almost three weeks, but have since recovered my health for the most part. I got on a walking program and have rebuilt my endurance. When I visited a cardiologist several months afterwards and described my symptoms and treatment, she was enraged when she heard I'd been sent home. When she looked at my discharge papers, (which I hadn't ever read) the diagnosis was "heart palpitations with anxiety" and no mention of the pericarditis they told me I had. She told me powerful antibiotics were not prescribed for heart palpitations, and questioned why there had been no follow-up recommendations for such a serious illness. When she contacted the attending doctor, he admitted that I had pericarditis, but could not explain why a different diagnois was put my discharge papers, or why I'd been sent home and not admitted to the hospital.
Here's my problem. Ever since the pericarditis, whenever I lie on my left side, it feels like I am lying on a rock, and that the rock is wedged right underneath the lowest rib on the left. Over the last few months, that uncomfortable feeling of something pinching or something not quite fitting in place has persisted and now affects me even when I am sitting up. There is no pain, only an truly uncomfortable feeling of pressure or fullness on that left side right under my last rib. When I press there, I can feel something hard that seems like it doesn't belong, and there is no similar area on my right side. Also, whenever I press the area, I get a strange sensation in my stomach and can actually hear and feel digestive juices sort of squishing along in there, but once again, no pain accompanies this, just a really weird sensation.
So, my question is this: can severe pericarditis produce enough pressure on the diaphram to cause a hernia, and are these symptoms consistent with a diagnosis of diaphramatic hernia? If so, what is the treatment I should seek, and which type of doctor should I see, a cardiologist or an internal medicine specialist?
Doctor's Answer
by CCF CARDIO MD JMF, Nov 15, 1999 12:00AM
It is very unlikely that pericarditis caused your diaphragmatic hernia. You may wish to see an internist to discuss this further.
