Pericarditis Simulating a Heart Attack

QUESTION: Our neighbor had a serious heart attack, but his wife claims it has
nothing to do with arteries or blood pressure. It developed just like one
though, but the diagnosis was called "pericarditis". Can you please explain
the condition for us? Thanks to rapid treatment he is doing well.
------------------------------------------------------------------------------
ANSWER: An attack of pericarditis can often resemble an ordinary heart
attack, as it starts with a chest pain that radiates to the left side of the
chest, shoulder and back, accompanied by shortness of breath. But the
similarity ends there.
While a "heart attack" results from the blockage of one of the arteries
that supplies blood to the heart, pericarditis is an inflammation of the
pericardium. The pericardium is a tough, fibrous sac that encloses the heart.
It can become inflamed following a viral or bacterial infection, often a
respiratory infection. The inflamed smooth inner surface of the pericardium
becomes roughened and rubs against the heart, producing the pain. In some
cases the pericardium produces more fluid than is necessary for lubrication,
and as the fluid accumulates inside the sac, it exerts pressure upon the
heart, so much so that the heart can not fill properly or beat as it should.
This condition is known as "Cardiac Tamponade" and is a most serious
complication of pericarditis. When the condition becomes life threatening, a
surgical approach may be necessary to drain the excess fluid and free the
heart from its constrictive envelope.
Treatment of the underlying infection, analgesics to relieve pain, and
diuretics (water pills) to reduce edema and swelling can produce excellent
results, but complete recovery can take from 2 weeks to three months to
achieve.