Treatments

Treatments for Pericardial Disease

To avoid more damage to the lining of the heart, you should limit exercise until the disease is controlled. Your physician may use medication, surgery or both to treat your condition.

Medical treatment may include:

• Non-steroidal anti-inflammation drugs (NSAIDs), such as aspirin, ibuprofen or indomethacin
• Other anti-inflammation medications, such as colchicine or steroids
• Other medications that can help reduce inflammation:
  • Rilonacept or anakinra, particularly for recurrent pericarditis
  • Azathioprine or IV immunoglobin, for some patients
• Antibiotic medications, for patients with a bacterial infection

Procedures and surgeries:

Northwestern Medicine Bluhm Cardiovascular Institute heart surgeons have received national recognition for performing rare and highly specialized surgeries for pericardial disease. They frequently perform the following procedures and surgeries:

Pericardiocentesis

• This treats pericardial effusion, especially if excess fluid is causing pericardial tamponade. Pericardial tamponade is a life-threatening condition.
• A physician inserts a needle to remove the excess fluid around the heart.
• Removing the excess fluid allows the heart to fill with blood and pump more easily. The fluid can be tested to find the cause of pericardial effusion.
• During this procedure, the physician uses echocardiography and fluoroscopy (an X-ray movie) to guide the needle.
• Sometimes a drain is left in for a few days and then removed.

Pericardial window

• This is a surgery during which a physician removes a small part of the lining around the heart.
• This creates a “window” that allows the excess fluid to drain out.
• This is used to treat recurrent pericardial effusion. This is more common in patients with cancer.
• This can also be used when draining the fluid is not an option.

Pericardiectomy

• This is a surgery during which a physician removes the lining around the heart.
• This allows the heart to fill with blood and pump more easily.
• This can help treat constrictive pericarditis cases or inflammatory pericarditis that does not respond to aggressive treatment with medication.