Heart & Cardiology/pericardial effusion

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Question
I have had chronic sinus inflammation for 8 months. Two months ago I started getting work ups from an ID doctor,ent,rheumatologist and immunologist. About20 vials of blood latter, all bloodwork was normal except measures of inflammation which were high but non specific. I was getting increasingly fatigued, winded and had a few occasions where I woke not being able to breathe, pacing, anxious and tried to lean forward to take a breath. The following day I had a ct of the Chest which showed a large pericardial effusion. I got an emergency appointment for an echo and meeting with a cardiologist an hour later and that night admitted the telemetry unit of the hospital. The following day, I had a liter of bloody fluid drained. I went home the following day. The fluid was tested and negative for infection, cancer, TB but positive for Inflammation.  I was re admitted three days later with a moderate to large effusion reforming which was causing the aortic chamber to collapse. The immunologist wanted me to have a biopsy to see it would provide a reason for the inflammation so I was transferred to a hospital with cardio thoractic surgery practice. They drained 3/4 liter of blood did a biopsy and window. So far the test results. Are negative except for Inflammation.  The tissue biopsy came back with a diagnosis of idiopathic pericarditis. The ent, rheumatologist and immunologist all feel that we are dealing with an autoimmune condition but don't know exactly what?  I am concerned that due to the inflammation, the window may scar over setting me up for another potentially dangerous effusion. I was put on an indomethacin and prevacid. What is my  next step?"

Answer
Hello again Amy,

Pericardial windows rarely scar over, almost never.

You should be taking colchicine and an NSAID like ibuprofen.to reduce the inflammation.

Please write back if this note doesn’t answer all your questions.

David Richardson

Heart & Cardiology

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David Richardson

Expertise

Adult heart function and disease. Not very good about children lesss than 12. Hypertension is o.k. Heart rhythm a special interest.

Experience

Certified in cardiology by the American Board of Internal Medicine. Was chairman of division of cardiology at the Medical College of Virginia. Am now mostly retired.

Organizations
Fellow of American Heart Association and American College of Cardiology and member of American Physiological Society..

Publications
Circulation, American Heart Journal, Hypertension.

Education/Credentials
M.D. from Harvard Medical School. Residency training at Yale Uhniversity School of Medicine and Medical College of Virginia.

Awards and Honors
Gold Heartt Award from American Heart Association in 1995.

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