Re: Pericarditis

Posted By CCF CARDIO MD-APS on January 20, 1999 at 12:17:00:

In Reply to: Pericarditis posted by Helen on January 15, 1999 at 23:40:33:






Dear Doctor,
I am a 36 year old female in excellent health except for a pacemaker inserted in May 98 for heart block. I developed pericarditis which did not respond to aspirin, NSAIDS or high doses of steroids. In the end the Dr. repositioned the ventricular lead as it was suggestive that it had migrated and was perhaps in the pericardium - suggestive only on trans-oesophageal echo and likely on CT scan. Friction rub and pain eased off quickly after movement of the lead. 4-5 months later I am feeling sharp pains again at ventricular lead area (under left breast) and once again have pericarditis with friction rub and pain. I live in the country and local physician phoned the specialist who put me on colchisine and betaloc for the recurrent tachycardia associated. My question is why would I get a recurrence and do you think it is possible that the lead could have migrated again? Please give me your opinion as I am a bid shocked that this whole thing has blown up again. It has been 7 months of hell and I have 3 beautiful children to care for and a wonderful husband and I am sick of being sick.
I am also interested in hearing from anyone who has suffered recurrent pericarditis and their thoughts.
Helen



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Dear Helen,
Although pericarditis can be a recurring problem, your first resistant episode
does sound like it was related to the pacer position, HENCE this should be investigated fully again
now that you have another episode, ESPECIALLY since your pericarditis is so resistant to medical
therapy.  Also keep in mind that just because the medicines (aspirins, NSAIDS, etc.) did not work
before, it does not mean it will not work in future episodes.  I think the pacer
lead placement should be investigated first, if not just repositioned to see if this affords
any relief as it did last time.  I am truly sorry for all your sick days, it is unusual for the pericarditis to not
just settle down on its own, but in a few cases like yours it is very difficult to control.  In general successive
episodes do tend to diminish in intensity.
Since your condition is unusual if not difficult to control, you should be followed regularly by a specialist, not just a local doctor.
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.