Pericarditis and heart rate

[Felecia__0__0]

  I am 30 years old and 29 weeks pregnant.  My primary care physician sent me to the emergency room about 2 weeks after I had chest pains and an irregular cardiogram.  After some blood tests and a sonogram of my heart, the cardiologist diagnosed me with periocarditis.  Apparantly my "sed rate" (something to do with inflammation) at the time was over 90.  Since the trip to the emergency room the chest pains have subsided but I continue to experience the following symptoms: racing heart (resting pulse 100)not necessarily related to exertion; incredible shortness of breath; persistent cough for about 2 months (chest hurts when i cough); and extreme fatigue.  I am anemic and have very low blood pressure (avg. 90/60). What do you think?  Thanks in advance.  

[CCF Cardio MD - MTR]

Dear Felecia, thank you for your question.   I did an extensive computerized search of the medical literature on the subject of pericarditis in pregnancy and I found it's a very rare condition.  I've attached a few abstracts detailing case reports on this subject to my response.  You can get copies of these articles at your nearest medical library.  The sed rate is a test to measure generalized inflammation and it can be elevated with pericarditis as well as with many other conditions that can cause inflammation (i.e. - rhematoid arthritis, lupus, an infection).  Your symptoms are consistent with pericarditis and there may be treatments to help alleviate your symptoms, but you would need to check with your cardiologist about that issue.  The anemia is probably not related to the pericarditis and the low blood pressure may be related, but I don't have enough information to comment much on these issues.  
I hope this information is useful. Information provided in the heart forum is for general purposes only.  Only your physician can provided specific diagnoses and therapies.  Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.   The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
Unique Identifier
94087676
Authors
Hagley MT.  Shaub TF.
Institution
Department of Medicine, Northeast Ohio Universities College of Medicine, Akron City Hospital, Akron.
Title
Acute pericarditis with a symptomatic pericardial effusion complicating pregnancy. A case report.
Source
Journal of Reproductive Medicine.  38(10):813-4, 1993 Oct.
Abstract
A 30-year-old, white woman, gravida 4, para 2, abortus 1, was hospitalized at 21 weeks' gestation because of a symptomatic pericardial effusion. Extensive evaluation including pericardial biopsy failed to reveal a specific cause. Treatment with pericardiotomy and intrapericardial hydrocortisone was followed by relief of symptoms. The remainder of the pregnancy was uneventful. Idiopathic pericardial effusion in pregnancy is a rare problem, and the proper approach to evaluation and treatment is not known. We present an approach that resulted in a favorable outcome.

Unique Identifier
89132689
Authors
Simpson WG.  DePriest PD.  Conover WB.
Institution
Department of Obstetrics and Gynecology, University of Kentucky College of Medicine, Lexington.
Title
Acute pericarditis complicated by cardiac tamponade during pregnancy.
Source
American Journal of Obstetrics & Gynecology.  160(2):415-6, 1989 Feb.
Abstract
A case of acute pericarditis, complicated by pericardial effusion and cardiac tamponade, is described.

Unique Identifier
78256646
Authors
Krausz Y.  Naparstek E.  Eliakim M.
Title
Idiopathic pericarditis and pregnancy.
Source
Australian & New Zealand Journal of Obstetrics & Gynaecology.  18(1):86-9, 1978 Feb.
Abstract
The association of idiopathic pericarditis and pregnancy is described in 3 patients. The disease preceded the onset of pregnancy in 2 patients and appeared during the sixth month in the third. All pregnancies reached term and the deliveries were uneventful. One patient had mild heart failure before the pregnancy. This deteriorated slightly during its course. The remaining 2 patients had no signs of heart failure and none of the 3 had arrhythmias or embolic phenomena. Two patients were treated with aspirin and prednisone and one was treated for heart failure only. All patientts are still symptomatic and require treatment 9 months, 1 year and 21 years after the pregnancy. Two of the patients underwent partial pericardiectomy.