Pericarditis - Not Feeling Pain but Feeling a little Fatigue When Lying Down

With some people the pain and breathing are worse while lying down. This is common. You might want to prop yourself up a bit with an extra pillow.

I have pericarditis right now. I definitely feel worse lying down.

Good luck. Let us know how your doc appt goes.

Hello everyone,

I am new to this site and have found it very informative, although I am sorry there are so many out there who are dismissed or misdiagnosed when presenting with pericarditis symptoms.  I believe that I had this for 3 months in 2012 and was shuffled from an ER, where I had the million dollar cardiac work-up and sent home (all clear from cardiac cath, EKG, ECG and cardiac enzymes), to my PCP who was convinced I had GERD. When treatment for that did not help and after having a completely clear upper endoscopy, he pretty much washed his hands and threw me back to cardiology. 

Well, by the time I got to a cardiologist, the symptoms had completely subsided. But just to make sure I had done everything I could to help rule out CAD, I scheduled a heart scan. The calcium score was "zero", meaning absolutely no calcification inside or outside of the scanned arteries.  The appointment with the cardiologist went well and he assured me that structurally there is nothing wrong with my heart, no blockages, ejection fraction was good and the muscle itself seemed strong, based on all of the medical documentation I had brought with me.  Unfortunately, since the symptoms had subsided, I still could not get a conclusive diagnosis.

On March 8, 2013, the pain in my chest began to creep in and by the middle of the afternoon I was in moderate discomfort.  I have worked in the disability field for years and for some reason, after all of this, I thought maybe this was pericarditis (the light went on).  I googled symptoms of pericarditis and I was having textbook symptoms.  I called the cardiologist, spoke to a nurse and she scheduled an appointment for me on 3/18/13, told me she was going to speak to the doctor and call me back.  Can I just say I love this office?!!  She called me back within 10 minutes and the doctor advised that I begin ibuprofen 800 mg 3x/day for inflammation.  But, if this did not help to relieve the pain, it probably was not pericarditis and to call them back.

Unfortunately, or maybe it was fortunate, it did not help and I ended up in th ER again a few days later with intense pain, but thankfully the ER doctor was willing to listen to the history and after all the cardiac protocals were completed and everything was normal, he ordered a CT scan, which showed the effusion.  I was admitted, given IV pain medication and began treatment with indocin.  I was in the hospital for nearly 3 days, but when the pain became manageable without IV dilaudid, I was allowed to go home.  I missed a week of work and hope to go back on Monday.

I guess what I want people to know is DO NOT let ER's send you home until they find out what is causing the pain.  I had 3 months of hell in 2012 and would not have if the ER doctor had had some real interest in determining the cause of the pain. I have been on Indocin now since 3/13/13 and the pain is manageable with aspirin and tylenol.  I am absolutely keeping the appointment on 3/18, and if the pain has not subsided more by then, meaning inflammation is reducing, I plan on speaking to the cardiologist about colchicine, as well. 

Thank you for reading this post.  I hope it helps someone struggling with these symptoms and cannot get a conclusive diagnosis. Insist on a CT scan and ECG--I truly believe had a CT scan not been performed, I would have had the same outcome as last year.

BlueRey, I would love to hear more about your condition that led to the decision to have the pericardiectomy....my husband has constrictive pericarditis, and it is time that we considered next steps, scary though they may be. Beth Louw Swellendam South Africa

pericarditis is easily diagnosed by properly reading an EKG and by symptoms. Unfortunately many young ER docs have not encountered this condition and do not recognize it. I was fortunate to have the second trip to the ER with a doc who did diagnose correctly. Rest and ibuprofen are the main cure. I also read everything on the net. I heard a gurgle in the heart one day and new immediately that it was fluid around the heart. The best natural diuretic is watermelon. I drove to the store bought a watermelon and ate the whole thing during that day and another one the next day. I also limited my water intake to try to dry myself out. It worked and I continue to eat watermelon but not near food intake as it will ferment. I have seen 2 naturopathic docs that specialize in heart conditions. I take a lot of supplements but do not have health insurance so I figure it is up to me to take care of this body. I am 60 years old and determined to recover. I slept 20 hours a day for the first month and you have to sleep almost sitting up. I tried to come off the ibuprofen at 4 weeks but had a bad attack. I think this condition has been lingering around the heart for years before it became bad. I had the shoulder pain and a little heart pain for a long time. A virus a week before the attack. I am not going to do prednisone or colchisine unless it is not gone at 3 months. Prednisone can cause it to come back later and colchisine can affect bone marrow. Ibuprofen is a miracle drug. I have no pain at 600mg every 4 hours. If i go longer i have some pain. dont stop the ibuprofen until it is all gone or the inflammation can come back. I am back at work but i try not to move too fast or stress my heart. Tai chi is my exercise and slow walks. good luck everyone.

I have had pericarditis for almost 8 weeks. for about 6 weeks I have had a strange red circle under my chin about 3 inches in diameter. It is red with a white ring around it. Any ideas what this is. thank you

I am only taking Ibuprofen. Can't find any info on what it could be. Could be a stone in a salivary gland. I am going to see my doc on Monday. She might have some ideas. I take 2400mg of Ibuprofen a day. It might be a reaction. Thank you Kitt, I dont think it is causing any problem. Sheryl

SW,  I am sorry you had a tough night.  I had a blocked salivary gland once and the whole left side of my face puffed up suddenly with pain into my ear and when I tried to chew.  My Dr. did order and MRI to check for any serious medical problem.

Here is a site that will answer questions re your concerns:

http://health.nytimes.com/health/guides/disease/salivary-duct-stones

Your pain and swelling concern me; do you have access to a walk-in- clinic or same day care clinic?  I would recommend that you call your Dr. or your clinic triage nurse and see what they advise you to do today.  It is a long week-end so today would be much easier to find someone to guide you.

Kindly,

Kitt

Kitt, I have seen my doc for my pericarditis. thought it was viral but I have or have had lyme disease. I have a bullseye mark under my chin. Now I think it is lyme. I am going to have a new test for lyme and some other tests. I might have to have fluid extracted and have it tested. My doc said to get accurate test it is tested on brain material . I may have to go to singapore for medical help. too expensive in the U.S. I have no insurance. Maybe just the lyme disease test and the bullseye are enough proof it is lyme related pericarditis. thank you for any advice, sheryl

johnathan, Have thy discovered the cause of your pericarditis. Fluid need to be extracted from the heart to area next to the heart to determine the cause. The cause needs to be treated so your pericarditis will not return. You are young you can recover and have a full life. get your doc to test the fluid. I think mine is from lyme disease. Dont give up you can be well in a few month if the cause is treated. Prednisone is not a good treatment and causes it to just come back. dont just stop the prednisone. talk to your doctor or get a new doctor that will test you. Stay positive and happy. You need to heal there is hope. You are young and you will have a happy life. It will get better. I am 60 years old but I know i will get better. Keep doing research on the internet. we are so lucky to have this to help us find out how to heal. In times past people just died without help and suffered. You can overcome this. Sheryl

Jonathan, have they tested you for lyme disease. I am only taking ibuprofen. I have returned to work. I only stayed home for the first month. You have to be careful taking meds that suppress the immune system. talk to your doc. this forum is very helpful and I see that others are in the same boat. I must say I have not suffered as much as others. I have no pain as long as I stay on 600mg every 4 hours but I cant do this forever. I have thought to go to singapore to have fluid extracted and tested. what if they cannot get any fluid like in your case, hmm, new dilemma. I thought I had this figured out. I am having lots of blood work done next week. my son is a doc and he thinks he can figure it out but maybe not. I am going to find out if i still have lyme and maybe that is the cause.we need a magic wand or the medical device from star trek to find the cause and treat the cause not just the result. have you been on colchisine with ibuprofen. I am still leary of trying the colchisine. I eat an extreme healthy diet. I juice kale,and eat mostly from my garden with some chicken. Black seed is suppose to cure all disease, I will try anything. Have hope Jonathan, do your research. best wishes, sheryl

Hi, this is sheryl. I still have signs of pericarditis. I went to the ER on May 3rd. I am on colchicine .6mg and 600mg ibuprofen every 4 hours 24 hours a day. Still cant back off on the ibuprofen or i have chest pain. I am going to start taking a baby aspirin also. almost 3 months on ibuprofen and no kidney or liver distress. Now we think my pericarditis is due to lyme disease. So I have gone back on lyme disease medication. I was bit by a tick 4 years ago, test positive and did the cure meds but evidently it did not get rid of it. I also have a bullseye mark on my neck. I have no symptoms of lyme so i thought it was gone. I did take a month off from work but i had to go back to work. But now i am on so many meds it is a full time job just to take the pills so i am going to take off some time until i get better. I think it will take 3 more months to get rid of this.i only started colchicine a few weeks ago. I think it is starting to work. I still have a lot of energy and i have not slept during the day for 2 weeks so i think i am getting better. I think i have a lot of fluid around the heart it kind of bounces when i am driving. good luck everybody. sheryl Being careful to not miss a dose of ibuprofen really helps with the pain.

Hi I'm John. 27 years old. Glad to read your experiences. Make me feel a little better. I've had pericarditis for 3 months now and was starting to feel hopeless. I've been reading a lot about pericarditis and was starting to think it might be forming into constrictive pericarditis. I'm glad to see people can still recover after the 3 month mark. The only question I have is, did anyone have elevated jugular vein pressure? I can actually feel the pressure in my neck going up to my right ear. It doesn't look distended but bothers me. Been feeling really short of breath because I've been cycling to work and my job is labor intensive. Going to have to stop working now that I see it's making it worse... Feeling hopeful that if I stop working and stick to the ibuprofen I will get better. Thank you for sharing and hopefully someone replies with some insight.