Exercise Induced Pericarditis

[HealThySelf]

I have severe three vessel CAD with a longstanding total occlusion of the RCA, a ruptured plaque in my left main and an ostial occlusion of the circumflex.



Since a heart attack 4 years ago, I have embarked on a program of aggressive lipid and bp control via multiple medications and daily exercise.  I've generally experienced very good health and physical ability over the last years as long as I walk a narrow path of taking good care of myself and getting my exercise.



I'm currently experiencing a very painful episode of inflamation of the pericardium, which I also experienced in May of this year.  In this case I went downhill skiing Christmas day.  I felt great, the snow was great, and I skied hard and fast all day.  Although I felt fine that night and the next day, I'm sure that I overdid it physically.  



Saturday I started experiencing stabbing pains in my chest which evolved into classic symptoms of pericarditis.  My heart itself seems unaffected in that I can walk uphill without angina and a nitro had no effect on the pain.



I can't seem to find any literature on people with CAD who experience short term bouts of inflammation of the pericardium due to over exertion.  



My question is:  Is short term inflammation of the pericardium a recognized phenomenon in people with CAD?  Is it possible that this is, as I suspect, just an inflammatory event provoked by too much physical activity, and not full blown pericarditus?



I do know that it can be prevented by leading a balanced life and the pain that I have experienced is a good incentive to remember that.



Happy Holidays,

WJS

[Cleveland Clinic]

sorry to hear about your pain.



I'm unaware of any association between exercise and pericarditis, and it is not supported by any literature. 70-80% of episodes are idiopathic and we never find a cause.    There is an association in patients after myocardial infarction and episodes of pericarditis, which might explain your recurrent symptoms. There are some other causes of recurrent pericarditis, if you are having frequent episodes it would be worth an evaluation to ensure that there are no other systemic causes.

Treatement is usually NSAID based. Steroids should not really be used  except in specialized cases, as some think they could lead to chronic syptoms.





Your should continue your aggressive lifestyle changes. It's probably kept you out of the woods as far as further events.



good luck

[HealThySelf]

Thanks for your reply.  Got in to my cardiologist yesterday.  Good EKG and can't hear any sign of Pericarditis.  He thinks it's my rib cage.  



Broke many ribs on my left side and my sternum when I was young and I guess that it just comes back to bite me from time to time.  I must have pulled something skiing or maybe it was just the chest expansion from a day of physical exersion.  But I can't believe the chain reaction to where my whole rib cage hurts like multiple stab wounds.  It hurts almost as much as when I broke all of those bones the first time.



Well anyway, I'm glad that my heart is doing fine and look forward to getting back on the straight and narrow path.  Think that I will ski a little easier until I get condtioned for it.



Thanks.