Our Summary

This research paper discusses a rare but serious heart condition called relapsing pericarditis, which can occur after heart-related surgeries. This condition is characterized by inflammation of the pericardium, the protective sac around the heart, causing severe symptoms. If the condition does not improve with medication, surgery to remove the pericardium may be recommended.

The paper shares a case study of a 33-year-old woman who developed this condition after getting a pacemaker for a heart rhythm disorder. Despite trying medications, her symptoms didn’t improve. Therefore, she underwent a robot-assisted surgery to remove all of her pericardium. This operation was done using a minimally invasive technique and led to a significant improvement in her symptoms. The authors suggest that this surgical approach should be considered for managing this rare but potentially debilitating condition.

FAQs

  1. What is relapsing pericarditis and what are its symptoms?
  2. What are the treatment options for relapsing pericarditis if medications do not work?
  3. How is a robot-assisted surgery used to treat relapsing pericarditis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pericardiectomy is to discuss the potential risks and benefits of the surgery thoroughly before making a decision. It is important for the patient to understand that while pericardiectomy can improve symptoms and quality of life, there are risks involved with any surgical procedure. It is important for the patient to work closely with their healthcare team to weigh these factors and make an informed decision about their treatment plan.

Suitable For

Patients who are typically recommended pericardiectomy include those with severe and persistent symptoms of relapsing pericarditis that do not respond to medical treatment. This may include patients who have undergone heart surgeries or procedures such as pacemaker implantation and develop inflammation of the pericardium as a complication. Pericardiectomy may also be recommended for patients with constrictive pericarditis, a condition where the pericardium becomes thickened and stiff, leading to impaired heart function.

Patients who experience symptoms such as chest pain, shortness of breath, fatigue, and fluid retention due to pericardial inflammation may be candidates for pericardiectomy. These symptoms can significantly impact a patient’s quality of life and ability to perform daily activities. In cases where conservative treatment options have been exhausted and the patient’s symptoms are severe and debilitating, surgery to remove the pericardium may be considered as a last resort.

It is important for patients to be evaluated by a cardiologist or cardiac surgeon to determine if pericardiectomy is the appropriate treatment option for their specific condition. The decision to undergo surgery should be made in consultation with a multidisciplinary team of healthcare providers who can assess the risks and benefits of the procedure and provide personalized care for the patient.

Timeline

Before pericardiectomy:

  • Patient develops relapsing pericarditis after heart-related surgery
  • Symptoms include chest pain, shortness of breath, fever, and fatigue
  • Patient tries medication to manage symptoms, but they do not improve
  • Surgery to remove the pericardium is recommended as a last resort

After pericardiectomy:

  • Patient undergoes robot-assisted pericardiectomy surgery
  • Surgery is successful in removing the pericardium
  • Patient experiences significant improvement in symptoms
  • Patient is able to recover and resume normal activities with reduced risk of relapsing pericarditis

What to Ask Your Doctor

  1. What is a pericardiectomy and why is it recommended in cases of relapsing pericarditis?

  2. What are the potential risks and complications associated with pericardiectomy surgery?

  3. How long is the recovery process following a pericardiectomy surgery?

  4. Will I need to take any medications or follow a specific treatment plan after the surgery?

  5. How likely is it that the relapsing pericarditis will recur after the pericardiectomy?

  6. Are there any alternative treatment options to consider before undergoing pericardiectomy surgery?

  7. How experienced is the surgical team in performing pericardiectomy procedures?

  8. What can I expect in terms of long-term outcomes and quality of life after undergoing a pericardiectomy?

  9. How closely will I need to follow up with my healthcare provider after the surgery?

  10. Are there any lifestyle changes or precautions I should take to prevent a recurrence of relapsing pericarditis after the surgery?

Reference

Authors: Balkhy HH, Patel BB, Spiller R, Avella-Patino D. Journal: Innovations (Phila). 2019 Oct;14(5):468-472. doi: 10.1177/1556984519861960. Epub 2019 Jul 24. PMID: 31337250