Pericarditis medication recommendations

Hi. I was diagnosed with Pericarditis in May. I have suffered with this since February. 5 months now. Still undergoing scans etc. Struggling with taking Ibubrofen alongside the Colcechine.. Can anyone recommend a different anti inflammatory I can take alongside Colcechine.

[Sunnie2day]

Hiya, Jac19, welcome to a club you really-really-really never wanted to join! Pericarditis bad enough to want medical attention is frankly awful.

I have recurrent pericarditis (since the late 1990s) and early on they discovered I can't tolerate Colchicine, and the only anti-inflammatory I can tolerate is aspirin. Luckily I have a cast-iron stomach.

Are you sure your problem with the meds is from the Ibuprofen, and not the Colchicine? If you're sure, ask your doctor if you can switch to plain aspirin. I take one 300mg but have permission to bump up to 2x300mg (total 600mg) as needed (once a day only) and I find the Boots brand tablet easiest to take and most effective - knocks dead that left side ache (that sometimes tries to mimic a heart attack with radiating pain up through shoulder to neck and down my left arm), so win-win for me.

Have they withdrawn any pericardial effusion fluid for testing or done bloods - is it bacterial, is it from an injury, is it the same infection ongoing since February? Do they think it's relapsing (meaning the initial infection hanging on) or are they starting to make 'Hmmm, this may be recurrent pericarditis' noises? (recurrent meaning the initial infection cleared but after a few weeks of feeling as though you were in recovery - whammo! Back came a whole new flare.)

I have SUCH empathy - I've only just fully cleared a ten month acute flare.

[Hidden in reply to Sunnie2day]

Hi Sunnie2day.

Thanks for the quick reply. Yes, a club I wish I wasnt drawn to. But!! I'm sure it will be a good support group. It's all still very new and scary. Not knowing and understanding the diagnosis.

Been on the Colcechine 8 weeks seem to be ok but will check out with GP.

Just really starting barrage of tests. Had an MRI this week, no heart muscle damage. Pericarditis fluid. Timeline =

Feb sudden severe chest / throat pain. A& E = ecg ok. Sent for gastroscopy slight stomach inflammation. Prescribed lansoperadol.

Mar severe pain a & e = CT scan showed pnuemonia. Antibiotics.

April same procedure Chest x ray = pnuemonia. Antibiotics.

May admitted to ward. Ecogramme- Pericarditis diagnosed.

Colcechine & Ibubrofen

Say now it could be recurring although throughout all this time. Pain never gone away. Always dull ache mainly in chest and back. Tired not able to carry out normal daily activities etc. Bliid tests yesterday for inflammation markers, then meds to be prescribed.

Awaiting ct heart scan may be auto immune ( idiopathic pericarditis )

Possible referral to rheumatology clinic.

A mind blowing and uncertain time just now.

[Sunnie2day in reply to Hidden]

Oh dear - if the 'final' diagnosis is recurrent, you're in for a very long haul indeed. The chest ache never really goes away but tapers back to a very low dull ache that (I hate to tell you this) you mostly get used to and eventually realise if it becomes a bit more than a low dull ache you can mostly ignore, it means you might be headed for an 'acute flare'.

Every pericarditis patient is different but there are some common helps effective for all - sleeping with your upper body elevated (per Smarticus' tip), avoiding heat and humidity (if you love long hot showers or soaks in a hot tub, you need to give those up), and avoiding mould.

Resting as much as possible - now is not the time to train for a marathon or start a large DIY project, for example.

Eating a well-balanced diet, keeping sodium/salt intake lower than usual (I find it helpful in preventing fluid retention - but check with your doctor to be sure lowering your salt intake to 3-4g only per day is appropriate for you).

It sounds as though you are being well-cared for, actually - the investigations being carried out will give the cardiologist good information towards a definitive diagnosis and creating a long-term treatment plan if it does turn out to be recurrent pericarditis.

Pericarditis that develops to the point of needing professional intervention is rare in the UK so many GPs don't recognise it, and many cardiologists haven't had a lot of experience treating it. There are a very few pericardial specialists in the UK but they're few and far between so far - that may be changing as Covid-19 is now being discovered to have long-term complications like pericarditis and medics are on 'crash course' to learn more.

But again, it does sound as though you're in good hands. Do ask about sodium/salt intake as you say you have some pericardial effusion, and do ask if you can use aspirin as your anti-inflammatory with the Colchicine.

ETA: Are you on a beta blocker?

[Hidden in reply to Sunnie2day]

Yes. I am trying to come to terms with the prospect of a long haul recovery.

Tiredness / lethargy difficult.

The dull ache is what I have been experiencing in between these flare ups and I am beginning to come to terms with. I can cope with the ache rather than the full blown chest / throat pain.

Not on beta blocker.

Will check out salt / sodium, aspirin therapies.

[Sunnie2day in reply to Hidden]

When I'm in an acute flare, and then the next weeks after it clears, I find myself so exhausted just walking from bedroom to bathroom to living room and kitchen. I have to stop and rest between rooms - I have total empathy for what you're going through.

It does pass, eventually, but while you're up in it, it feels as though it will never be better.

I was in an acute flare when my GP ordered a low-dose beta blocker+aspirin (Bisoprolol 1.25mg+300mg aspirin once a day) for what was then suspected angina (confirmed in November 2019 via angiogram - I've won such a lottery ) and it not only helped the angina, it seemed to have a positive effect on the chest pain from the pericarditis as well - not completely removed but apparently my 'exceptionally strong heartbeat' was annoying my pericardium (pericardial effusion). And now I've cleared the acute flare and recovered, I'm noticing that dull ache isn't as noticeable.

Everyone is different but if you have a strong heartbeat, you may want to ask your medics if a beta blocker might be appropriate for you.

Any road, keep us updated. There are more than a few pericarditis patients on this board and they all have excellent tips for coping-recovery-avoiding a new flare.

[Hidden in reply to Sunnie2day]

Thankyou for all this information. It is very helpful.

The last 24 hours since joining the forum I feel I have learnt such a lot and that I'm not alone in this.

I will certainly update as my treatment / condition progresses.

Thank you 👍

[Sunnie2day in reply to Hidden]

No need to reply but have you seen this BHF page on pericarditis? I found it very informative:

bhf.org.uk/informationsuppo...

[Smarticus]

Hi, so... I'm not a doctor obviously, but I have had severe pericarditis... perhaps speak to your GP about Indometacin. HTH

Edited to add webmd.com/drugs/2/drug-8880... and to say try and keep upright as much as possible, sleep with a couple of pillows (on your back - which i hate), if you can for a couple of weeks a reclining chair...

[Hidden in reply to Smarticus]

Hi. Thanks for that. Will look into it. Awaiting blood test results. Will see what is suggested by Cardiologist.