So what causes this? What causes pericarditis?

Well, I’ll be honest with you. In most patients, the exact cause is never identified. We call that idiopathic pericarditis. However, many cases of idiopathic pericarditis are believed to be triggered by viral infections, so that’s a key point here.

Now, there are other causes, including autoimmune diseases such as lupus, rheumatoid arthritis, kidney failure, certain medications, cancer, chest trauma, radiation, and yes, even heart surgery, which is what I do.

In fact, pericarditis is relatively common after cardiac surgery, and it’s known as post-pericardiotomy syndrome, or Dressler syndrome.

So how do we diagnose it?

Doctors use a combination of the patient’s symptoms, physical examination, electrocardiograms or EKGs, certain blood tests that look for inflammation, and echocardiography, which is very important. Occasionally, we’ll use CT scans or even MRI studies.

Well, once you have it, how do you treat it?

The treatment depends on the cause and the severity. For most patients, anti-inflammatory medications are the cornerstone of treatment. These include ibuprofen, aspirin, and other nonsteroidal anti-inflammatory drugs.

A medication known as colchicine, which some people with gout are familiar with, has become an important part of treatment because it helps reduce inflammation and may lower the risk of recurrence.

In patients with recurrent or difficult-to-treat pericarditis, steroids or newer immunomodulating therapies may be used.

Now, here’s an important thing. If fluid accumulates around the heart, which it can with pericarditis, it can impair the function of the heart. A procedure called pericardiocentesis, in which a drain is placed percutaneously, or even a surgical procedure known as a subxiphoid pericardial window, may be needed to drain that fluid.

So let’s talk about the elephant in the room, and that is: can vaccines cause pericarditis?

The answer is yes, but it’s actually more uncommon than you might think.

Cases of pericarditis and myocarditis, which is inflammation of the heart muscle itself, have been reported after several vaccines over the years. This is actually nothing new.

Some of those vaccines include the smallpox vaccine and, more commonly, the COVID-19 vaccines.

So let’s talk about that.

With the mRNA COVID-19 vaccines, the risk appears to be highest among adolescent and young adult males, typically occurring within a few days after vaccination.

Fortunately, most reported cases have been mild and have resolved with treatment and rest.

But let’s keep it in perspective. COVID-19 infection itself, which is still around, can cause pericarditis. It can cause myocarditis. It can cause blood clots, heart attacks, and many other cardiovascular complications.

In fact, the risk of heart inflammation from the infection is higher than the risk associated with vaccination.

As physicians, we continue to monitor the data carefully, but the overwhelming evidence suggests that serious vaccination-related pericarditis is rare. For most individuals, the benefits of vaccination have clearly outweighed the risk of getting the disease.

The bottom line is this:

Pericarditis is inflammation of the sac surrounding the heart. Most cases are treatable. Many resolve completely. With proper diagnosis and management, the vast majority of patients do well regardless of the cause, including vaccination-related pericarditis.

That’s a lot.

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(𝘛𝘩𝘦 𝘷𝘪𝘦𝘸𝘴 𝘦𝘹𝘱𝘳𝘦𝘴𝘴𝘦𝘥 𝘪𝘯 𝘮𝘺 𝘱𝘰𝘴𝘵𝘴 𝘢𝘳𝘦 𝘮𝘺 𝘰𝘸𝘯 𝘢𝘯𝘥 𝘥𝘰 𝘯𝘰𝘵 𝘳𝘦𝘱𝘳𝘦𝘴𝘦𝘯𝘵 𝘵𝘩𝘦 𝘷𝘪𝘦𝘸𝘴 𝘰𝘧 𝘮𝘺 𝘦𝘮𝘱𝘭𝘰𝘺𝘦𝘳 𝘰𝘳 𝘢𝘯𝘺 𝘰𝘳𝘨𝘢𝘯𝘪𝘻𝘢𝘵𝘪𝘰𝘯.)