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Heart Disease  (Expert Forum)
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Re: Pericarditis
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.

Re: Pericarditis

by CCF Cardio MD - MTR, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD - MTR on June 21, 1998 at 20:33:29:

In Reply to: Pericarditis posted by Ken on June 20, 1998 at 14:24:49:






I had pericarditis 10 years ago when I was 27.  I had a pericardial effusion and persistant RBBB for awhile afterwards.  My heart skipped beats for awhile after that and then I didn't have any more problems until recently.  The cardiologist at the time thought I could have had cardiomyopathy but my symptoms improved.  Lately  I had bad spells of tachycardia, ST and T wave changes,  and  left atrial enlargement, and  PVC's.  I had an event monitor  which also  showed PSVT.  The ECG's keep showing left and right atrial enlargement but the echo  only showed borderline left atrial enlargement.  I'm  taking Toprol now that really  helps with the PVC's and the PSVT but the  other day  while I was walking it  felt like my  heart was ratteling.. it was the strangest feeling and worried me a little but after about 30 seconds it stopped.
My quesstion is.. does it sound like I have anything to worry  about or should  I  just try and forget all  these  symptoms since PVC's and PSVT is a common problem.  Do you think these symptoms are related to the fact that I had pericarditis 10  years ago?  The cardiologist wasn't  tooo  sure if I had just pericarditis or  if I had myopericarditis.
Ken






_
Dear Ken, thank you for your question.  Pericarditis is an inflammation of the
pericardial sac that covers the heart.  Normally, there is a small amount of
fluid in the pericardial space between the sac (called the pericardium) and the
heart that allows the heart to beat without friction against the pericardium.
Inflammation can be caused by infections (most commonly viral, but TB is the most
common cause in third world countries), autoimmune disorders (the body makes
antibodies against its own tissues), uremia (build up of toxins in the blood from
kidney failure), and after open-heart surgery or a heart attack (the heart muscle
becomes inflamed while trying to heal).  Myocarditis is an inflammation of the
heart muscle itself (often from similar causes), but is more concerning because
congestive heart failure can develop.  It sounds like you had pericarditis, and
not myocarditis 10 yrs. ago from what you mention.  Whether there was residual
damage to the pericardium and heart muscle from the episode of pericarditis that
could be causing your current symptoms is doubtful.  PSVT (paroxysmal supraventricular
tachycardia) occurs when a fast heart rhythm from the top chambers of the heart
is sustained by "looping" through an extra conduction pathway in the heart.  When
PSVT occurs, patients can often terminate an episode by pressing against their
carotid arteries or by straining very hard like in having a bowel movement. You
may have had a short episode of PSVT the other day when your heart was "rattling."
PVCs are premature beats from the ventricle that make the native heart rhythm
irregular giving the sensation of a "skipped" beat.  Both PSVT and PVCs can be
suppressed by beta blockers (Toprol) which slow the heart rate and dampen the
heart's response to stress and hormones that usually causes PSVT and PVCs.  Also,
eliminating caffeine, tobacco, and alcohol can limit the number of PVCs that occur.
PSVT can also be cured through a procedure called an RFA (radiofrequency ablation).
In an RFA, the electrical system is mapped with special catheters inserted into
the right side of the heart and an abnormal pathway can be eliminated by applying
short bursts of radiofrequency energy.  Your cardiologist should be able to provide
more details.  However, your symptoms would have to be severe to consider this
procedure.  I hope you find this information useful.
Information provide in the heart forum is for general purposes only.  Specific
diagnoses and therapies can only be provided by your physician.



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