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In today’s podcast, Natalie Tornese, Senior Group Manager at Practice and Revenue Cycle Management: Healthcare Division, Managed Outsource Solutions discusses pericarditis – types, symptoms and treatment.

In this Episode

00:19 What is pericarditis?

Pericarditis is the inflammation of the pericardium – a thin, two-layered sac that surrounds your heart. Acute condition may last from a few days to a few weeks.

01:44 Types and Symptoms

Acute types of pericarditis include Incessant and Recurrent pericarditis. Common symptoms include sharp pain in the chest, swelling of the abdomen or legs, shortness of breath, pain in the shoulder and cough.

04:00 Pericarditis treatment

Treatment includes medications like pain relievers and Corticosteroids to reduce the inflammation and swelling associated with the condition. Patients will require hospitalization, if the physician suspects cardiac tamponade.

Hello everyone and welcome to our podcast series. My name is Natalie Tornese and I’m a Senior Group Manager at Practice and Revenue Cycle Management: Healthcare Division, Managed Outsource Solutions. I wanted to talk a little bit about Pericarditis.

Pericarditis is the inflammation of the pericardium – a thin, two-layered sac that surrounds your heart. The swelling can lead to sharp pain as the affected pericardial layers rub together causing irritation. Pericarditis is an inflammatory condition, usually acute, coming on suddenly, and lasting from a few days to a few weeks. However, when symptoms develop more gradually or persist, it is considered chronic. Both types – acute and chronic pericarditis can disrupt your heart’s normal rhythm or function. Most cases of this condition are mild and usually improve on their own. On the other hand, treatment modalities for severe cases may include medications and rarely surgery.

Reports suggest that about five percent of people who go to the emergency room for chest pain have pericarditis. It is estimated that about 15 – 30 percent of people with it will have it more than once. The exact cause is often hard to determine, but viral infections are thought to be responsible for 80 to 90 percent of the cases. The condition can develop weeks after a major heart attack or heart surgery. Other related causes include – systemic inflammatory disorders (like rheumatoid arthritis or lupus), trauma, kidney failure, parasites, radiotherapy and use of certain medications such as penicillin, warfarin, and phenytoin.

The types of Pericarditis and their symptoms are they can be classified into different types, depending on the pattern of symptoms and how long these symptoms last. Acute pericarditis usually lasts less than three weeks. Incessant pericarditis is continuous and lasts about four to six weeks but less than three months. Recurrent pericarditis, on the other hand lasts for about four to six weeks after an episode of acute pericarditis with a symptom-free interval in between. However, the condition is considered chronic if symptoms last longer than three months. Common symptoms include -

  • Sharp pain in the chest (sometimes central, other times to the left, that may decrease in intensity when sitting up and leaning forward)
  • Swelling of the abdomen or legs
  • Shortness of breath, especially when reclining
  • Palpitations
  • Pain in the shoulder
  • Minor fever
  • General weakness and
  • Cough

Symptoms, in most cases are very similar to a heart attack. It is imperative to seek medical attention if the patient experiences any pain in the chest. If left untreated, the condition can get worse and lead to several complications like - cardiac tamponade (too much fluid builds up in the pericardium) and constrictive pericarditis (a permanent thickening and scarring of the pericardium).

Cardiologists or other specialists will begin the diagnosis by analyzing the complete medical history of the patient and asking questions about the chest pain and other related symptoms. Physician will perform a detailed physical exam (to check the heart sounds), as part of their initial evaluation. They will check for the characteristic noise of pericarditis (also called a pericardial rub), which is made when the pericardial layers rub against each other.

Physicians may also perform tests to determine whether the patient has suffered a heart attack, whether the fluid has collected in the pericardial sac or whether there are signs of inflammation. Blood tests may also be done to determine if a bacterial or other type of infection is present. Other diagnostic imaging tests include an ECG, Cardiac magnetic resonance imaging (MRI) and a CT scan or a Chest X-ray.

Treatment depends on the cause as well as the severity. Mild cases may often get better on their own without treatment. Medications like pain relievers (like Advil, aspirin and any type ibuprofen, Motrin) and Corticosteroids may be prescribed to reduce the inflammation and swelling associated with the condition. If the physician suspects cardiac tamponade (a dangerous complication due to fluid buildup around the heart), patients will require hospitalization. If it is present, physicians may recommend procedures like pericardiocentesis to relieve the fluid buildup.

Cardiologists or other specialists providing treatment for pericarditis must carefully document the diagnosis using the right medical codes. I will include a transcript along with this podcast, outlining the specific ICD-10 codes associated with this condition.

In most cases, mild cases of pericarditis can be effectively managed by consuming over-the-counter medications and taking adequate rest. During the recovery stage, patients need to avoid strenuous physical activity as these can trigger pericarditis symptoms.

Hope this helps. But always remember that documentation and a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the services or procedures performed.

Thank you!