Pericarditis

After 3 months post pacemaker insertion --I am really beginning to feel myself again.  I have been put on Pindolol and that seems to take care of the over-riding rate beyond the pacemker settings.  I have begun my regular activity schedule including aerobics, hiking etc.  I started having chest tightness and SOB--After a stress test to rule out CAD--my MD said I continue to have a small effusion/pericarditis.  Question one-- what is the difference between these two?  Second--how long can this last? I have been out on VIOXX to relieve the pain and starting to accumulate fluid in my hands etc.  up 6 pounds from my normal weight.  I do feel so much better though --this is a small price to pay....

Thank you for your time and expertise.

[CCF CARDIO MD - DLB]

An effusion is fluid around the heart. Pericarditis is inflammation around the heart - fluid does not need to be present for this to occur, but there often is. It usually resolves completely within a few weeks. The fluid accumulation and weight gain are somewhat concerning, as this would not be expected from uncomplicated pericarditis. Sometimes the fluid around the heart and the inflammation can keep the heart from pumping effectively. If the situation worsens with time, further evaluation will be necessary.

[Peter]

If there is inflamation (inflammation) but no fluid present can this inflamation (inflammation) be seen on echocardiogram?If there is no fluid with what tests is pericarditis diagnosed?Thank you.Peter

[CCF CARDIO MD - DLB]

Inflammation alone cannot be seen on the echo, but can often be seen on the ECG.

[ginny]

Dear Doctor,
Is the indicator called heart block or lack of electrical transmitability as demonstrated on the ECG?  Also, what segment of the ECG is affected? Is it the QRS segment?
Thanks,
Ginny

[CCF CARDIO MD - DLB]

The PR segment, ST segment and T wave can all be affected.

[Laura K.]

My question is about pericarditis.  A friend of mines then 9 year old daughter had an infection.  She was put on Augmentum (sp?) very shortly after starting the antibiotic, she broke into a rash all over her body, was experiencing SOB, racing heartbeat, sore joints and difficulty walking.  She then was diagnosed with rheumatoid athritis and percarditis.  She underwent surgery shortly afterward and they removed 1000 (one thousand) ounces from around her heart.  She was put on 19 dangerous drugs and was given chemotherapy, although her mother still doesn't know why she was given it.  She fought being sick for 4 years untill she passed away recently at the age of 13.  A nurse mentioned to my friend she had heard that augmentum had been known to cause an anaphylactic reaction with similar symptoms that my friends daughter presented shortly after starting the drug.  I was wondering if you have seen anything like this before and if you think that the augmentum was possibly the cause of her sickness.  Also, why do you think that chemotherapy was used in a case of pericarditis and rheumatoid athritis?  I would appreciate any information you could give me on this.  My email address is lkay_y7***@****.  Thank you in advance.  Laura

[CCF CARDIO MD - DLB]

Any antibiotic can cause anaphylactic shock, although it is extremely rare. However, that is almost certainly not what caused the series of events that transpired in this case. It sounds like she had rheumatoid arthritis and chemotherapy is used in advanced cases.