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Pericarditis ongoing
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Pericarditis ongoing

Hi,
I've been having very sharp chest pain since March 29th, which is in a specific spot on my upper left chest and radiates through to my back. It's worse when I lie down or take a deep breath. I was admitted to the cardiac ward in the hospital on the 5th of April and was diagnosed with viral pericarditis. My chest x-ray was normal, but the ekg and a few other factors support this diagnosis. I was told I could leave the hospital when I felt my pain was under control, and I left a week later and was given painkillers. I have been taking anti-inflammatory pills, as well as codiene and even oxycodone because the pain is very severe and prevents me from sleeping especially. I am eager to get off the painkillers, however the pain is still as severe as when I first got the condition and does not seem to be improving at all. I recently had an echocardiogram, which appeared normal (except for a few 'leaks' which are apparently of no concern). I also experience mild fever (which is controlled by paracetemol) and breathlessness. I often wake in the night feeling as though I can't breathe, and the pain is still too severe to lie down properly. It has now been almost a month, and I'm just wondering if my symptoms are normal for this condition, or when I can expect improvement. At the moment I'm unable to work or study, in fact it is a struggle to even leave bed. It has now been five weeks and symptoms have not improved. The pain has spread a little to under the breast and centre of the chest. Is this normal, and when can I expect improvement? How do I know if there has been a complication or when I should seek further help?
Thank you kindly for your help.
Avatar_dr_m_tn
This is a concerning situation -- although most cases of viral pericarditis resolve without long-term effects, occasionally the inflammation and pain persist for quite some time.  Also, additional cardiac complications can result, such as constrictive pericarditis due to scarring/calcification of the pericardium (fibrous layer of sac surrounding the heart).

First I recommend using high dose anti-inflammatory (high dose aspirin OR ibuprofen OR naproxen, etc) in combination with a medication called colchicine. Hopefully focusing on reducing the inflammation would help your pain.  Second I recommend an echocardiogram as soon as possible to make sure that your heart continues to function well (rule out pericardial effusion or thickening).

Ultimately I think you will most likely recover from the pain and do well, but we need to be mindful of the potential for complications.  Good Luck!
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Avatar_f_tn
ruby, when a doctor says something is "concerning,' that means 'Go see a doctor.'

Since you are in Australia, you are probably going to have to battle your health care system to be examined soon by a cardiologist, but soon is what is needed here.
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