parcarditis

  My husband (age 33)  had aortic valve replacement (St. Judes)  on 9-22 due to possible aortic disection and heart enlargement from Marfans. He was then readmitted 1week later w/ fluid around the heart .  He now has parcarditis, but no more fluid.  He is in severe pain, mostly after sleeping, to the point he can't sleep more than two hours.  The surgeon has him on ibuprophen and steroids, percocet and keflex.  He keeps telling us it will go away, he knows it hurts, but it will pass. This seems to be slowing his recovery as he doesn't feel like walking or doing the rehab he should be doing.  He is now 4 weeks postop and it doesn't seem like he'll ever get better, or the pain will ever go away.  Do you have any words of encouragment?  Is there anything else we should be doing?  What about heat, ice, etc.   He had a CT scan today, Dr. is sticking w/ diagnosis of paracarditis, but wants the CT just for sure to check behind the incision for infection.  He doesn't want to open my husband up again for the 3rd time only to find his original diagnosis of paracarditis. The pain is terrible, for both of us.  Why do some people seem to get all of the symptoms and others heal w/ no problem?  Especially at 33, he should be doing better.  

[CCF CARDIO MD APS]

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Dear Janet,
The condition you speak of is called "pericarditis" or simply put inflammation around the heart.
The pathophysiology of pericarditis is not completely understood, however it does seem to occur in a good
portion of those patients who have had open heart surgery- at least to some degree.  Unfortunately, some patients
experience more of the symptoms than others, i.e. pain, and it takes a good 6 weeks on average for the process to
settle down and resolve.  The price your husband is paying is high, however, he should keep in mind that the procedure he
had was life-saving (many Marfans' patients die of ruptured aortas) and that the
process is temporary.  It appears that he is receiving excellent care and evaluation.  The medications he is on are the only
proven treatment of pericarditis (ibuprofen and steroids), the percocet is to control the pain so that he can attempt daily
exercise and recovery.  Good Luck.
Information provided in the heart forum is intended for general medical informational purposes only, actual diagnosis
and treament can only be made by your physician(s).