Pericarditis and Pregnancy

by Sam Malone

The pericardium is a double layered membrane covering the heart. The pericardium has several important functions, including protecting the heart from injury, acting as an anchor to keep to heart attached to the chest muscles and as a lubricant to enable the proper pumping of blood to and from the heart. As a result, when the pericardium gets irritated or inflamed it could cause a number of symptoms.

The inflammation of the pericardium is known as pericarditis. In most cases, pericarditis can be treated at home and does not require hospitalization. The three types of pericarditis are – acute, recurring and chronic. Acute pericarditis symptoms do not last for more than three months. In most cases a viral infection is responsible for this type of pericarditis. Recurring pericarditis occurs when symptoms of acute pericarditis reappear over time. The third type of pericarditis is chronic pericarditis. Though the symptoms of this type of pericarditis are milder, they last for more than three months and could cause more long-term damage to a person’s health.

In most cases of pericarditis, the exact cause of the condition is often unknown. Possible causes include viral infections, bacterial infections, and fungal infections. Other possible causes include other diseases such as leukemia, HIV/ AIDS, hypothyroidism, kidney failure, tuberculosis, heart attack, surgery to the chest, certain medications that suppress the immune system, and radiation therapy to the chest. Pericariditis is the most common in men aged between 20 to 50 years.

Pericarditis during pregnancy is not a common occurrence. A condition known as hydro pericardium may develop during the third trimester of pregnancy. This involves a silent pleural effusion that may affect up to 40 percent of all healthy pregnant women. Variations of pericardial disease can also occur during pregnancy as a result of:

Excessive water retention
High weight gain during pregnancy
Bacterial or viral infections
Hypertension
Renal failure
Autoimmune diseases

Symptoms of pericarditis during pregnancy may include:

Chest pain that is dull or sharp and sudden
Chest pain that radiates from the chest to the shoulders and neck
Pain increases when lying down and eating
Shortness of breath
Mild fever and chills
Swelling of the ankles, feet, and legs
Dry cough
Fatigue
Feelings of anxiety
Nausea

Treatment for Pericarditis during Pregnancy

Due to the several restrictions on medications used during pregnancy, pericarditis symptoms should be monitored closely. NSAIDs and anti-inflammatory drugs with antibiotics may be prescribed for short periods of time but never in the first trimester of pregnancy. Colchicine, which is an alternative for NSAIDs cannot be taken if pregnant.

Electrocardiographic changes and other physiological symptoms may require hospitalization and closer monitoring. Procedures such as drainage for pericarditis can be performed safely during pregnancy. Known as pericardiocentesis, the procedure involves the use of an echocardiography-guided needle that is inserted into a small hole in the pericardium allowing the excess fluid to drain off.

With respect to any sort of treatment, regular evaluation for drug reactions or any other complications needs to be maintained throughout the pregnancy. The outlook for a normal delivery and childbirth is positive. Pericarditis rarely causes birth defects in babies or increases the chance of recurrence in future pregnancies. Since symptoms of pericarditis usually disappear in two to three months, no further treatment of the condition is required.

Though the condition of pericarditis is not common during pregnancy and pregnant women do not show any specific susceptibility to the disease, precautions regarding diagnosis and treatment should still be taken. If possible, pregnancy should be planned during the latter phase of the disease.

References:

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