Pericarditis is an inflammation of the pericardium, a sac surrounding the heart. The most common form is acute pericarditis, which can usually be treated without hospitalization. Common in adolescents and young adults, acute pericarditis affects males more than females. Pericardial effusion is a form that results when fluid builds up in the pericardium. It is a more serious condition that can require hospitalization and possibly surgery. Constrictive pericarditis is a form that is a chronic condition and worsens gradually over a long period of time. It may ultimately require surgery. Pericardial effusion and constrictive pericarditis can occur together.

The signs and symptoms of pericarditis vary somewhat.

Acute pericarditis:

• Chest pain
• Fever
• Flushed appearance
• Muscle pain
• Pain with swallowing
• Feelings of anxiousness, discomfort, or uneasiness

Pericardial effusion:

• Difficulty breathing
• A bluish skin color

Constrictive pericarditis:

• Difficulty breathing
• Congestion in the lungs
• Fatigue
• Abdominal swelling

Acute pericarditis and pericardial effusion have a large number of possible causes, including viruses, bacteria, fungi, cancer, trauma to the heart (such as chest injury), drug reactions, and radiation exposure. In many cases, however, the actual cause is unknown. Constrictive pericarditis usually results from repeated cases of acute pericarditis.

Your health care provider will listen to your heart and lungs, take your pulse, and probably tap your chest and back. Your provider will probably order a number of tests, which may include blood work, an electrocardiogram, an echocardiogram, chest X ray, computed tomography (CT) scan, or magnetic resonance imaging (MRI).

Pericarditis is usually treated with aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen), but steroid medications may be prescribed.

Alternative therapies may have benefit as supportive treatments for some of the causes of pericarditis. Hawthorn (Crataegus monogyna) is a cardiac tonic with very low toxicity that could be used along with whatever therapy your provider deems most appropriate.

• Vitamin C (1,000 mg three times per day) may help decrease inflammation. It also aids in fighting infection, and is an antioxidant.
• Coenzyme Q10 (50 mg bid) is an important antioxidant that may help prevent heart muscle damage and speed recovery.
• Your provider may recommend sodium restriction if you have constrictive pericarditis.
• If your pericarditis is of viral origin, your provider may recommend supplementation with vitamin A (300,000 IU/day for 3 days).
• Flaxseed oil (3 g twice per day) helps decrease inflammation.
• Avoid saturated fats, alcohol, and sugars, which can lead to increased inflammation and lowered immune function.
• Consume at least five servings of fruits and vegetables per day. These foods are anti-inflammatory and protect the heart.

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day.

• Hawthorn (Crataegus monogyna) can help prevent high blood pressure and hardening of the arteries. Dose is 60 drops tincture three times per day 1 tsp. berries steeped for 10 minutes in hot water, or 100 to 250 mg three times per day as a supplement.
• Linden (Tilia cordata) is used for high blood pressure with nervous tension, and may be useful adjunctive treatment where there is anxiety. Dose is 1 tsp. dried blossoms per cup hot water three times a day or 60 drops tincture three times a day.
• Blue monkshood (Aconitum napellus) has been described as an herbal remedy for pericarditis without significant effusion. CAUTION: As this herb can be highly toxic, even fatal, it is not recommended unless prescribed by an experienced health care provider.

Some of the most common remedies used for pericarditis are listed below. Usually, the dose is 3 to 5 pellets of a 12X to 30C remedy every one to four hours until your symptoms get better.

• Aconite for sudden, sharp pains accompanied by anxiety (especially fear of dying) and restlessness
• Spongia tosta for the sensation that the chest will explode, anxiety, light-headedness, sweating; patient may be flushed
• Cactus grandiflorus for the feeling that there is a band around the chest or a great weight on the chest; palpitations; feels better in the open air and worse at night

Can be very helpful in decreasing inflammation, enhancing immune response, and regulating cardiac function.

Your provider may order a follow-up X ray or electrocardiogram.

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