What treatments are available for patients with pericarditis?

Medications

Treatment for acute pericarditis may include medication for pain and inflammation, such as ibuprofen and aspirin. Depending on the cause of your pericarditis, you may need an antibiotic or antifungal medication.

If your symptoms are severe, last longer than 2 weeks, or clear up and then return, your doctor may also prescribe an anti-inflammatory drug called colchicine. Colchicine can help control the inflammation and prevent pericarditis from returning weeks or even months later.

If you need to take large doses of ibuprofen, your doctor may prescribe medications to ease gastrointestinal symptoms. If you take large doses of nonsteroidal anti-inflammatory drugs (NSAIDs), you will need frequent follow-up appointments to look for changes in your kidney and liver function.

If you have chronic or recurrent pericarditis, you may need to take NSAIDs or colchicine for several years, even if you feel well.A diuretic (“water pill”) usually helps get rid of the extra fluid caused by constrictive pericarditis. If you develop a heart rhythm problem, your doctor will talk to you about treatment.

Your doctor may also talk to you about treatment with steroids or other medications, such as azathioprine, IV human immunoglobulins, anakinra.

Other treatments

Most times, medications are the only treatment needed for patients with pericarditis. But, if fluid builds up in the pericardium and compresses the heart, you may need a procedure called pericardiocentesis. A long, thin tube called a catheter is used to drain the extra fluid. The catheter and a needle are guided to the pericardium with the use of echocardiography. If the fluid cannot be drained with the needle, a surgical procedure called a pericardial window is performed.

If you have constrictive pericarditis, you may need to have some of your pericardium removed. The surgery is called a pericardiectomy.

Surgery is not usually used as treatment for patients with recurrent pericarditis, but your doctor may talk to you about it if other treatments aren’t successful.

Last reviewed by a Cleveland Clinic medical professional on 05/03/2019.

References

  • Cremer PC, Kumar A, Kontzias A, Tan CD, Rodriguez ER, Imazio M, Klein AL. Complicated Pericarditis: Understanding Risk Factors and Pathophysiology to Inform Imaging and Treatment. J Am Coll Cardiol. 2016 Nov 29;68(21):2311-2328. doi: 10.1016/j.jacc.2016.07.785.
  • Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015 Nov 7;36(42):2921-64. doi: 10.1093/eurheartj/ehv318. Epub 2015 Aug 29.
  • Klein AL, Abbara S, Agler DA, Appleton CP, Asher CR, Hoit B, Hung J, Garcia MJ, Kronzon I, Oh JK, Rodriguez ER, Schaff HV, Schoenhagen P, Tan CD, White RD. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. 2013 Sep;26(9):965-1012.e15. doi: 10.1016/j.echo.2013.06.023.
  • Xu B, Harb SC, Cremer PC. New Insights into Pericarditis: Mechanisms of Injury and Therapeutic Targets. Curr Cardiol Rep. 2017 Jul;19(7):60. doi: 10.1007/s11886-017-0866-6.

At Cleveland Clinic, we have a special center dedicated to the treatment of Pericarditis. To help people evaluate all available options for treating pericarditis, Cleveland Clinic's specialists have prepared a free downloadable Pericarditis Guide to help patients better understand their condition and their treatment options.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy