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Heart Disease (Expert Forum)
ongoing 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.
ongoing pericarditis
by flowerysuec, Sep 19, 2002 12:00AM
i am now into my 16th week after being diagnosed with viral pericarditis. indomethacin 150mg and co-codamol have been prescribed. i can walk for 0.5 of a mile without too much discomfort but about 2 hours later and for the next 3 days i am in great pain ;constant central chest pressure and short stabbing pains again c/chest. ?when can i expect to feel better and does v peri sound right? this last month i have also been prescribed amytripiline to help me sleep? vx shows low probibility clots/ echo x3 shows only small amount of fluid at base of heart/ all blood tests clear no attack. pressure 115/70 constant. age 44 male normally fit and active.
Doctor's Answer
by CCF-M.D.-RCJ, Sep 19, 2002 12:00AM
flowerysuec,
Thanks for the question.
Recurrent/persistent pericarditis can be difficult to treat. The most appropriate therapy is not definitively known, in part because the condition is not common.
The first item of business is to secure the diagnosis of pericarditis. Make sure that you feel comfortable with the manner in which the diagnosis was made -- by a cardiologist?, was an echo done?, was an EKG done? etc.
I've included a paragraph from the June 2 1998 Circulation journal. The summary statement is that colchicine is the drug associated with the most success in treating long-term pericarditis.
"Fifty-one affected patients (36 men and 15 women; mean +/- SD age, 40.8 +/- 18.7 years) who were treated with colchicine to prevent further relapses were followed up for <or=to 10 years (range, 6 to 128 months; mean, 36.0 months). The pericarditis was idiopathic in 33 patients and secondary in 18. Despite treatment with NSAIDs (n=47), corticosteroids (n=29), pericardiocentesis (n=8), or some combination thereof, 187 recurrences (mean, 3.58 +/- 3.64; range, 2 to 15) were noted before colchicine therapy was initiated, with a mean interval between crises of 2.0 months (range, 0.5 to 19 months). During 1004 patient-months of colchicine treatment, only 7 of 51 patients (13.7%) presented with new recurrences. Colchicine was discontinued in 39 patients, and 14 of them (35.8%) experienced relapses. These recurrences were generally minor and were effectively controlled in all patients by the reinstitution of colchicine therapy, sometimes with a dose adjustment of the drug (<or=to2 mg/d). Gastrointestinal side effects were mild (diarrhea and nausea) and resolved in all patients. During the 2333 patient-months of follow-up, 31 patients (60.7%) remained recurrence-free. Comparison of the symptom-free periods before and after colchicine treatment yielded significant statistical differences (3.1 +/- 3.3 versus 43.0 +/- 35.0 months, P<0.0001). The authors concluded that colchicine was effective and safe for the long-term prevention of recurrent pericarditis."
Our experience at the CCF is to start treatment with 0.5 mg po bid of colchicine.
Talk to your doctor. Colchicine may or may not be right for you depending on your medical history.
Good luck.
Thanks for the question.
Recurrent/persistent pericarditis can be difficult to treat. The most appropriate therapy is not definitively known, in part because the condition is not common.
The first item of business is to secure the diagnosis of pericarditis. Make sure that you feel comfortable with the manner in which the diagnosis was made -- by a cardiologist?, was an echo done?, was an EKG done? etc.
I've included a paragraph from the June 2 1998 Circulation journal. The summary statement is that colchicine is the drug associated with the most success in treating long-term pericarditis.
"Fifty-one affected patients (36 men and 15 women; mean +/- SD age, 40.8 +/- 18.7 years) who were treated with colchicine to prevent further relapses were followed up for <or=to 10 years (range, 6 to 128 months; mean, 36.0 months). The pericarditis was idiopathic in 33 patients and secondary in 18. Despite treatment with NSAIDs (n=47), corticosteroids (n=29), pericardiocentesis (n=8), or some combination thereof, 187 recurrences (mean, 3.58 +/- 3.64; range, 2 to 15) were noted before colchicine therapy was initiated, with a mean interval between crises of 2.0 months (range, 0.5 to 19 months). During 1004 patient-months of colchicine treatment, only 7 of 51 patients (13.7%) presented with new recurrences. Colchicine was discontinued in 39 patients, and 14 of them (35.8%) experienced relapses. These recurrences were generally minor and were effectively controlled in all patients by the reinstitution of colchicine therapy, sometimes with a dose adjustment of the drug (<or=to2 mg/d). Gastrointestinal side effects were mild (diarrhea and nausea) and resolved in all patients. During the 2333 patient-months of follow-up, 31 patients (60.7%) remained recurrence-free. Comparison of the symptom-free periods before and after colchicine treatment yielded significant statistical differences (3.1 +/- 3.3 versus 43.0 +/- 35.0 months, P<0.0001). The authors concluded that colchicine was effective and safe for the long-term prevention of recurrent pericarditis."
Our experience at the CCF is to start treatment with 0.5 mg po bid of colchicine.
Talk to your doctor. Colchicine may or may not be right for you depending on your medical history.
Good luck.
Member Comments (2)
by Impotant1, Sep 19, 2002 12:00AM
I also had the Pericarditis for 3 months. Nothing helped but the steroid "Prednisone". I don't think it's real safe if you've had a heart attack. They started me off on 60mg at the E.R. and within a half hour I felt perfect. Then they gave me a script that lessens your dose till your off them in 10 days or so. Except I was'nt cured yet. I think the fluid gets infected even if it is a small amount. Nobody could tell me what caused it except maybe caused by an underlying infection. That made sense cause I had an abscess tooth 2 days before my heart attack. Every breath I suffered & it would get worse to the point I could'nt lie down at all..or sleep. Side effects of the Prednisone for me was it kept me awake at night and I became a little on the aggresive (aggressive) side. I swelled up a bit and my neck got thick. So have your doctor do a blood culture and also make sure you don't have acid reflux. Oh and by the way I just got that rotten abscess tooth out this morning, and I'm feeling alot better tonight. I also had trouble swallowing and my upper chest hurt often besides the Percarditis symtoms.
