If you’ve developed pericarditis more than once, you may have recurrent pericarditis. This means that you have another episode of acute pericarditis that happens at least a month after your first episode. About one-fourth of patients who had a pericarditis episode will have another within two years, and 15% will have multiple recurrences.
Fortunately, there are many treatments to help you live with it. There are also things you can do to make it easier to manage the condition. Here are some tips to try:
Keep in Touch With Your Doctor
If you have been diagnosed with pericarditis, you will need to see a cardiologist regularly. This will allow them to:
- Keep a close eye on your heart
- Watch for symptoms of a recurrence
- Create a plan to treat your pericarditis and to prevent another recurrence
When you had your original episode of pericarditis, your doctor most likely did a thorough workup to see if you had an underlying health condition that triggered your symptoms. Oftentimes, the initial cause of pericarditis is a viral infection. But other conditions that could lead to it include:
- Heart attack
- Surgery
- An inflammatory condition like lupus
- Kidney failure
- Cancer
If your pericarditis was due to any of the above, your doctor will want to refer you to a specialist who can help treat the condition.
Be Aware of Suspicious Symptoms
It’s important to be aware of the signs of pericarditis, if it recurs. These can include:
- Chest pain that worsens if you cough, take a deep breath, or lie down. It feels better if you sit up or lean forward.
- Shortness of breath
- Heart palpitations
- Fever
- Cough
- Swollen stomach, legs, or feet
- Dizziness or lightheadedness
Call your doctor immediately if you notice any of these symptoms.
Scale Back on Exercise
If you have another bout of pericarditis, it’s very important that you limit your activity. Your doctor may want to clear you and run blood tests to look for lingering signs of inflammation, such as C-reactive protein. They may also want to do another electrocardiogram to be sure your heart has returned to normal.
Even if you’re not an athlete, you’ll want to take it easy with workouts. Your doctor may want you to stick to walking and to keep your heart rate under 100 beats per minute for as long as you’re under treatment for pericarditis.
Tweak Your Sleeping Style
It’s important to get enough rest when you have pericarditis to help your body heal. But you may find it hard to get comfortable. If you are a side sleeper, it may hurt to sleep on your left side. It may also be hard to breathe if you lie on your back. It’s a good idea to sleep propped up on pillows to stay elevated. You may also find that a heating pad or hot water bottle on your chest helps you feel better.
Lead a Healthy Lifestyle
If you have recurrent pericarditis, it’s very important that you take steps to protect your heart and stay healthy. Things you can do include:
- Eat a healthy diet. Focus on high-fiber foods like fruits and vegetables, and limit salt and processed foods. Also watch your alcohol intake since it can raise your blood pressure.
- Keep a healthy weight. If you have excess weight or obesity, it puts more stress on your heart.
- Get regular exercise. As long as you do not have acute pericarditis, it’s important to stay active. It’s recommended that adults get a minimum of 2 1/2 hours of moderate intensity exercise, like brisk walking, every week.
- Don’t smoke. It raises your risk of heart disease.
- If you have high blood pressure, elevated cholesterol, or type 2 diabetes, make sure you have those conditions under control.
Adjust Your Work Schedule
If you have recurrent pericarditis, you may find that there are periods of time during a flare when it’s difficult to work. You should let your employer know. You may be eligible for accommodations under the Americans with Disabilities Act (ADA). Some of the things you may be entitled to include:
- The ability to work from home
- Flexible schedule and flexible leave. You may need to take time off of work, for example, during an acute flare.
- Eliminate physical activity. If your job requires you to move around, you may have to avoid that during a flare.
- Rest breaks
Rarely, people with recurrent pericarditis develop a condition called constrictive pericarditis. This is permanent scarring of the pericardium that can lead to heart failure. In these situations, you may be eligible for Social Security disability benefits. The Social Security Administration has its own specific requirements that you must meet if you have diagnosed heart failure. Your doctor can help you figure out if you qualify. You can apply for benefits online or at your local Social Security office.
Try New Treatments
At first, your doctor may recommend a nonsteroidal anti-inflammatory drug (NSAID) or aspirin along with another drug, colchicine. Both help to relieve inflammation. If this doesn’t make you feel better, they may add a steroid.
About 15% to 30% of all patients don’t get help from the above medications. If you’re one of them, your doctor may recommend a new FDA-approved drug, rilonacept (Arcalyst). It’s a type of drug called an interleukin (IL) 1 inhibitor. It blocks the action of IL-1 cytokines, which are the inflammatory compounds that cause pericarditis. Another option is a drug that suppresses your immune system, such as azathioprine.
As a last result, your doctor can drain fluid from the pericardium or even remove your pericardium.
Take Care of Your Mental Health
Research shows that patients who live with recurrent pericarditis report a poor health-related quality of life and even say that they have problems with sleep quality and work productivity. It may help to connect with other people who live with pericarditis for support. One good place to start is the Pericarditis Alliance.
Most of the time, recurrent pericarditis can be safely managed. But if you develop any symptoms or have questions about your condition, reach out to your doctor.
Show Sources
Photo Credit: iStock/Getty Images
SOURCES:
Journal of the American Heart Association: “US database study of clinical burden and unmet need in recurrent pericarditis.”
Myocarditis Foundation: “How to Prepare for Pericarditis Recovery.”
Cleveland Clinic Journal of Medicine: “Is exercise restriction necessary in patients with pericarditis?”
New York Presbyterian: “Pericarditis.”
Job Accommodation Network: “Heart Condition.”
UptoDate: “Constrictive Pericarditis: Diagnostic Evaluation,” “Recurrent Pericarditis.”
FDA: “FDA Approves First Treatment for Disease That Causes Recurrent Inflammation In Sac Surrounding Heart.”
American Heart Association: “Recurrent Pericarditis.”
Heart Failure Society of America: “Applying for Social Security Disability Benefits with Heart Failure.”
American Journal of Cardiology: “Burden of recurrent pericarditis on health-related quality of life.”
Cardiology in Review: "Rilonacept and Other Interleukin-1 Inhibitors in the Treatment of Recurrent Pericarditis."
