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Treatment of Pericarditis

Due to the difficulties associated with the organization of treatment in Turkey, Switzerland, South Korea and India, we are not currently processing requests to these regions.

If you are interested in treatment in Germany, please leave a request and our specialists will contact you as soon as possible.

 

Cost for treatment

Pericardial drainage to treat pericarditis
 from  6191
Pericarditis differential diagnosis and conservative treatment
 from  6003
Cardiac rehabilitation
 from  566.57

St. Vincentius Hospital Karlsruhe-Academic Hospital of the University of Freiburg

9.8/10
location_onGermany, Karlsruhe

Department of Cardiology, Angiology and Intensive Care Medicine

The St. Vincentius Clinic is the largest multidisciplinary medical institution and academiс hospital of the Albert Ludwig University of Freiburg. Treatment and diagnosis of patients is conducted by doctors with a scientific degree. They are introducing the latest progressive techniques. The clinic has at its disposal the latest
Pericardial drainage to treat pericarditis
18397 help16397
Pericarditis differential diagnosis and conservative treatment
17821 help15821

University Hospital Ulm

8.7/10
location_onGermany, Ulm

Department of Cardiology, Angiology and Internal Intensive Care

The University Hospital Ulm started its activities 35 years ago and during this time it has become one of the most prestigious medical institutions in Europe. The hospital is famous for its numerous discoveries and the world-class achievements in medicine and pharmaceuticals. The medical facility has 29 specialized departments a
Pericardial drainage to treat pericarditis
18416
Pericarditis differential diagnosis and conservative treatment
15350

Charite University Hospital Berlin

9/10
location_onGermany, Berlin

Department of Cardiology and Angiology

According to the authoritative Focus magazine, the Charite University Hospital Berlin occupies the first place in the rating of the top German medical facilities! The hospital is one of the largest and leading university medical complexes in Europe. The hospital in Germany provides modern diagnostics and treatment of patients, a
Pericardial drainage to treat pericarditis
25916
Pericarditis differential diagnosis and conservative treatment
24316

University Hospital Heidelberg

9.8/10
location_onGermany, Heidelberg

Department of Cardiology, Angiology and Pulmonology

According to the Focus magazine, the University Hospital Heidelberg ranks among the top five hospitals in Germany! The hospital is one of the most advanced and reputable medical institutions not only in Germany, but throughout Europe. There are more than 43 specialized departments and 13 medical institutes, which cover all field
Pericardial drainage to treat pericarditis
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Pericarditis differential diagnosis and conservative treatment
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University Hospital RWTH Aachen

8.7/10
location_onGermany, Aachen

Department of Cardiology, Pulmonology and Angiology

According to the prestigious Focus magazine, the University Hospital RWTH Aachen ranks among the top German hospitals! As a maximum care university medical facility, the hospital guarantees patients first-class medical services combined with a respectful and human attitude. The hospital integrates all the modern options for the
Pericardial drainage to treat pericarditis
20012
Pericarditis differential diagnosis and conservative treatment
18645

University Hospital Frankfurt am Main

10/10
location_onGermany, Frankfurt am Main

Department of Cardiology and Angiology

According to the reputable Focus magazine, the University Hospital Frankfurt am Main ranks among the top German medical facilities! The hospital was founded in 1914 and today is a well-known German medical facility, which combines rich traditions and scientific innovations. A medical team of more than 6,500 employees cares about
Pericardial drainage to treat pericarditis
17427
Pericarditis differential diagnosis and conservative treatment
16686

University Hospital Jena

8.9/10
location_onGermany, Jena

Department of Cardiology, Angiology, Pulmonology and Intensive Care

According to the prestigious Focus magazine, the University Hospital Jena regularly ranks among the top German medical facilities! The hospital has positioned itself as a multidisciplinary medical facility with a long history of more than 200 years. Since its foundation, the hospital has been constantly developing and modernizin
Pericardial drainage to treat pericarditis
19845
Pericarditis differential diagnosis and conservative treatment
18433

University Hospital Erlangen

9.1/10
location_onGermany, Erlangen

Department of Cardiology and Angiology

According to the Focus magazine, University Hospital Erlangen ranks among the best medical facilities in Germany! The hospital is one of the leading healthcare facilities in Bavaria and offers top-class medical care distinguished by the close intertwining of clinical activities with research and training of medical students. The
Pericardial drainage to treat pericarditis
18997
Pericarditis differential diagnosis and conservative treatment
15302

University Hospital Würzburg

9.2/10
location_onGermany, Würzburg

Department of Cardiology, Endocrinology, Nephrology and Pulmonology

According to the Focus magazine in 2019, the University Hospital Würzburg ranks among the top national German hospitals! The hospital is one of the oldest medical facilities in Germany. The centuries-old traditions of first-class treatment are combined with the very latest achievements of modern evidence-based medicine and
Pericardial drainage to treat pericarditis
17441
Pericarditis differential diagnosis and conservative treatment
16695

University Hospital of Ludwig Maximilian University of Munich

10/10
location_onGermany, Munich

Department of Cardiology

According to the Focus magazine, the University Hospital of Ludwig Maximilian University of Munich is regularly ranked among the best medical institutions in Germany! The hospital is the largest multidisciplinary medical facility, as well as a leading research and training center in Germany and Europe. The hospital is proud of i
Pericardial drainage to treat pericarditis
19891
Pericarditis differential diagnosis and conservative treatment
16265

University Hospital Duesseldorf

9.5/10
location_onGermany, Duesseldorf

Department of Cardiology, Pulmonology and Angiology

According to the authoritative Focus magazine, the University Hospital Duesseldorf ranks among the top Germany hospitals! The hospital is an excellent example of a combination of high-quality health care, research and teaching activities. With more than 50,000 inpatients and about 300,000 outpatients every year, the hospital is
Pericardial drainage to treat pericarditis
19852
Pericarditis differential diagnosis and conservative treatment
18328

University Hospital Marburg UKGM

8.6/10
location_onGermany, Marburg

Department of Cardiology, Angiology and Internal Intensive Care

The University Hospital Marburg UKGM offers patients modern diagnostics and comprehensive therapy at the international level. As a maximum care hospital, the medical facility specializes in all fields of modern medicine ranging from ophthalmology to traumatology and dentistry. The main areas of specialization of the hospital are
Pericardial drainage to treat pericarditis
16392
Pericarditis differential diagnosis and conservative treatment
15793

University Hospital Halle (Saale)

9.6/10
location_onGermany, Halle

Department of Cardiology, Angiology and Internal Intensive Care

According to the prestigious Focus magazine, the University Hospital Halle (Saale) ranks among the top German medical facilities! The history of the hospital has more than 300 years, and during this time it managed to earn an excellent reputation not only in Germany, but throughout the world. The hospital positions itself as a s
Pericardial drainage to treat pericarditis
17618
Pericarditis differential diagnosis and conservative treatment
16731

University Hospital Rechts der Isar Munich

9.8/10
location_onGermany, Munich

Department of Cardiology, Angiology and Pulmonology

According to the prestigious FOCUS magazine, the University Hospital Rechts der Isar Munich ranks among the Germany's top medical institutions! Founded in 1834, the hospital combines long traditions and the very latest achievements of modern medicine. The medical facility includes 33 specialized departments, 20 interdiscipli
Pericardial drainage to treat pericarditis
19982
Pericarditis differential diagnosis and conservative treatment
18457

University Hospital Bonn

9.2/10
location_onGermany, Bonn

Department of Cardiology, Angiology and Pulmonology

According to the authoritative Focus magazine, the University Hospital Bonn ranks among the top ten medical facilities in Germany! The hospital was opened on January 1, 2001, although in fact it inherits the medical facility, which operated at the Faculty of Medicine of the University of Bonn. The hospital in Germany combin
Pericardial drainage to treat pericarditis
19678
Pericarditis differential diagnosis and conservative treatment
18300

University Hospital Muenster

9.8/10
location_onGermany, Muenster

Department of Cardiology

According to the Focus magazine, the University Hospital Muenster ranks among the top German hospitals! The hospital belongs to the most prestigious medical institutions in Germany. The hospital is distinguished by a high professionalism of its doctors, state-of-the-art technological equipment and the availability of the most ad
Pericardial drainage to treat pericarditis
17501
Pericarditis differential diagnosis and conservative treatment
16862
| from Booking Health GmbH

The pericardium is the "bag" that surrounds the heart. It consists of two layers. Inflammation of the pericardium is called pericarditis. This disease is characterized by fluid accumulation between the two layers. The result of inflammation can be irreversible damage to the pericardium, fusion of its layers, scarring and deposition of calcium salts. Pericarditis treatment for most patients is conservative. The development of severe acute or chronic forms of the disease requires invasive procedures and surgery. Doctors in developed countries give preference to minimally invasive transcatheter and thoracoscopic interventions. Such treatment is associated with minimal trauma, rarely causes complications, and allows patients to recover quickly.

Content

  1. Causes
  2. Clinical course of pericarditis
  3. Symptoms
  4. Diagnostics
  5. Conservative treatment
  6. Surgical treatment
  7. Why is it worth undergoing treatment for pericarditis abroad
  8. Treatment in Europe at an affordable price

Causes 

 

Pericarditis is classified by origin. The disease is divided into two large groups: infectious and non-infectious.

There are 7 variants of infectious pericarditis:

  • Bacterial nonspecific.
  • Specific (for example, developing due to syphilis, brucellosis, cholera).
  • Tuberculous.
  • Chlamydial.
  • Rheumatic (autoimmune damage to the pericardium due to streptococcal infection of another localization).
  • Viral (herpes, enterovirus, adenovirus).
  • Casuistic (that is, very rare) – caused by amoebas, molds, parasites, etc.

The second large group is non-infectious or aseptic pericarditis. There are eight types of this pathology:

  • Allergic and drug-induced (pericarditis is most often caused by cytostatics, antiarrhythmic drugs and antibiotics).
  • Autoimmune.
  • Traumatic (including due to surgery, electric shock, etc.);
  • Developing against the background of systemic connective tissue diseases;
  • Developing against the background of blood diseases.
  • Developing due to oncological pathologies;
  • Associated with metabolic disorders (endocrine disorders, liver or kidney failure, gout);
  • Idiopathic (of unknown origin).

Clinical course of pericarditis 

 

The pericardial diseases are not common European diseases. In the developed countries of Europe, this pathology accounts for only 0.2% of all reasons for hospitalization. The real prevalence of the pathology is higher than the number of diagnoses, but the disease often proceeds with mild symptoms, so patients do not always seek medical help.

In countries with poorly developed medicine, tuberculosis predominates among the causes of pericarditis. It accounts for up to 70% of all diagnoses. The mortality rate in this type of pericarditis is very high: it reaches 40%.

In developed countries, viral or non-infectious pericarditis is more common. Mortality rate in the acute form of the disease is about 1%.

Acute bacterial pericarditis caused by Staphylococcus aureus is characterized by the worst prognosis. Mortality rate in case of this pathology reaches 75-80%. Nonetheless, it occurs infrequently: about 1% of all types of pericarditis.

According to the clinical course, pericarditis can be: 

  • Acute – resolves within 4 weeks. 
  • Chronic – lasts more than 3 months. 

After the treatment of acute pericarditis, three quarters of patients are cured once and for all. However, in 25% of cases, relapses occur. In some patients, the disease becomes chronic. The advancement to chronic fibrinous or constrictive pericarditis is considered an unfavorable outcome of the pathology. Its likelihood differs depending on the origin of the disease. With viral pericarditis, 1% of cases of pathology progress into the fibrinous form, with autoimmune pericarditis – 5%, with a bacterial infection – 30%. This is a consequence of damage to the pericardium with the formation of scar tissue followed by the deposition of calcium salts.

There are four types of chronic pericarditis. These types can also be called stages, since they successively replace each other with the progression of the disease:

  • Exudative (with liquid inside).
  • Adhesive – the formation of adhesions between the layers of the pericardium, as well as between the pericardium and adjacent organs, but these adhesions do not interfere with cardiac activity.
  • Constrictive – the formation of adhesions and scars that disrupt cardiac activity. 
  • Armored heart – a manifestation of advanced constrictive pericarditis, this is the hardening of the pericardium due to the deposition of calcium salts.

Even in the most severe cases, treatment for pericarditis can be successful. But if the pericardium is irreversibly damaged, doctors have to remove it during surgery. After such treatment, the 20-year survival rate of patients averages 75%, and in countries with advanced medicine, it exceeds 85%.

Symptoms 

 

The dominant symptom of pericarditis is pain in the area of the heart. It is associated with movement, and can be intensified by coughing and deep inhalation. The pain is usually constant, of moderate intensity. It weakens or disappears with the patient sitting forward.

Other clinical manifestations occur in the case of cardiac tamponade, if too much fluid accumulates around the heart. In this case, a person may experience symptoms that resemble heart failure. The person's heart rate increases, shortness of breath, cough, weakness appear, and blood pressure decreases.

The development of cardiac tamponade results in the classic triad of signs, known as the Beck's triad:

  • Low blood pressure.
  • Muffled heart sounds on auscultation.
  • Elevated jugular venous pressure.

All classic symptoms manifest themselves only in case of severe pericarditis with rapid fluid accumulation. In this event, when examining the patient, the doctor can see swollen jugular veins in the neck. The patient may also have pain in the right hypochondrium due to stagnation of venous blood in the liver.

Another classic manifestation of cardiac tamponade is pulsus paradoxus. It is weak when inhaling and becomes stronger when exhaling. When measuring blood pressure, a medical specialist can find that when inhaling it is 10 mmHg or more lower than when exhaling.

Diagnostics 

 

To establish a diagnosis of acute pericarditis, three out of four criteria are required: 

  • Pain in the area of the heart. 
  • Pericardial friction rub that can be heard with a phonendoscope.
  • Characteristic changes in the electrocardiogram.
  • Detection of pericardial effusion using instrumental diagnostic methods. 

Echocardiography (ultrasound of the heart) is most commonly used for heart imaging. The doctor can detect the effusion, evaluate its effect on hemodynamics, and measure the "thickness" of the effusion.

A CT scan and MRI of the heart are more accurate diagnostic tests. They are used less often, only if echocardiography was not informative enough.

In countries with poorly developed medicine, chest x-rays are still used for heart imaging. Nevertheless, this examination is informative only in case of the development of cardiac tamponade with accumulation of at least 300 ml of exudate.

To determine the causes of pericarditis, laboratory diagnosis is used. Doctors carry out tests for infections and antibodies that can damage the heart due to the presence of autoimmune pathologies. General clinical examinations are carried out to assess the function of the liver, kidneys and other internal organs.

Conservative treatment 

 

Pericarditis is not always severe. Sometimes the effusion around the heart is slow and small. In this case, the effect on hemodynamics is minimal.

The treatment mostly involves the use of conservative therapy. Doctors prescribe nonsteroidal anti-inflammatory drugs. Anti-inflammatory drugs of other pharmacological groups are less commonly used. These can be corticosteroids and colchicine. Doctors in developed countries also treat patients with interleukin-1 receptor antagonists.

Therapy is also aimed at eliminating the cause of pericarditis, if it was possible to establish it, and if this cause must be eliminated. For example, bacterial pericarditis requires long-term antibiotic therapy. In case of inflammation of the pericardial sac of herpes origin, doctors use acyclic nucleosides that suppress the replication of the virus.

Surgical treatment 

 

Severe cases of the pathology cause a very quick accumulation of fluid in the pericardial cavity, which results in the development of cardiac tamponade. The heart cannot contract normally, as it is compressed from the outside by the liquid. In such situations, emergency surgery or invasive procedures are performed.

To remove the contents of the pericardial cavity, the following methods can be used:

  • Pericardiocentesis.
  • Intrapericardial thrombolysis.
  • Surgical drainage.
  • Long-term drainage, which is required in case of constant accumulation of fluid in the pericardial cavity.

Pericardiocentesis is the pumping of fluid from the pericardial cavity with a thick needle. In developed countries, this procedure is safe, and therefore it very rarely leads to complications. The doctor inserts the needle under the guidance of ultrasound or computed tomography.

Intrapericardial thrombolysis is a single-stage procedure. The doctor injects fluid into the pericardial cavity, which dissolves blood clots. The medical specialist may additionally administer anti-inflammatory drugs, antibiotics, and other medications.

Surgical drainage of the pericardium is rarely used. It is required in cases where the fluid located inside the pericardial cavity is too thick and cannot be pumped out with a needle. For example, pus has accumulated around the heart due to bacterial pericarditis or blood clots have appeared. In addition, after trauma or due to some congenital anomalies, the anatomical features of the chest can become an obstacle to pericardiocentesis. In such situations, patients also require a surgical intervention.

Long-term drainage is used for severe pericarditis, when more than 1 liter of fluid accumulates in the pericardial cavity. It continues in parallel with the treatment aimed at eliminating inflammation. The drainage is stopped after the volume of fluid released per day decreases to 30 ml. This procedure makes the treatment of pericarditis more effective. It reduces the risk of recurrence of cardiac tamponade by 5 times within the next 12 months.

Even without cardiac tamponade, pericarditis can become chronic. Gradually, the pericardial sac thickens, thickens and becomes scarred. Then calcium salts are deposited on it. Some patients develop constrictive pericarditis, which leads to chronic pain.

Here are some of the surgical treatment options for chronic pericarditis: 

A pericardial "window" is the formation of the outflow tract to direct fluid from the pericardial sac into the pleural cavity. This surgery is required for the malignant course of pericarditis, characterized by the constant fluid accumulation.

Doctors in developed countries of Europe use minimally invasive methods for performing this surgery:

  • Thoracoscopy, which is the surgery performed through short incisions in the chest, using video endoscopic equipment.
  • Balloon pericardiotomy is a surgical procedure with the insertion of a balloon catheter through a needle, which is then inflated, thereby dilating the opening in the pericardium.

Pericardiectomy is a radical treatment method that involves the removal of damaged parts of the pericardium. Another name for this surgery is cardiac decortication. This is an open surgical procedure that requires a sternotomy (a large incision in the center of the sternum). Pericardiectomy is used in cases where the pericardium is irreversibly damaged, and other treatment methods are futile.

Why is it worth undergoing treatment for pericarditis abroad 

 

Any heart disease, even the most severe one, can be successfully treated abroad. Timely high-quality therapy allows curing acute pericarditis, preventing it from becoming chronic. Even in the advanced stage of the disease, modern drug therapy regimens and minimally invasive interventions make it possible to get rid of chest pain and eliminate effusion in the pericardial sac.

There are several reasons for you to undergo treatment in one of the countries with advanced health care system:

  • High-precision diagnosis allows determining the origin and mechanism of development of pericarditis.
  • Therapy is aimed at eliminating the cause of the disease.
  • Most types of acute pericarditis can be completely cured without the use of invasive procedures and surgical interventions.
  • Successful treatment of even severe forms of bacterial pericarditis.
  • Most patients undergo minimally invasive procedures to remove effusion instead of surgery.
  • The use of minimally invasive thoracoscopic interventions or balloon pericardiotomy in order to form the outflow tract for pericardial effusion.

Treatment in Europe at an affordable price 

 

To undergo treatment in one of the European hospitals, you can use the services of the specialists working in Booking Health. On our website, you can find out the cost of treatment in Europe, compare prices and book a medical care program at a favorable price. The treatment in Europe will be easier and faster for you, and the cost of treatment will be significantly lower.

You are welcome to leave your request on the Booking Health website. Our medical advisor will contact you within 24 hours. The medical tourism operator from the Booking Health company will take care of the organization of your trip for medical treatment in Europe. We will provide the following benefits for you:

  • We will choose a hospital for treatment in Europe, whose doctors specialize in the treatment of pericarditis and achieve the best results.
  • We will help you overcome the language barrier and establish communication with your attending physician.
  • We will reduce the waiting time for the medical care program. You will receive medical services on the most suitable dates.
  • We will reduce the price. The cost of treatment in a European hospital will be lower due to the lack of overpricing and additional coefficients for foreign patients.
  • We will solve all organizational issues, such as paperwork, hotel booking, transfer from the airport to the hospital. An interpreter will accompany you abroad.
  • We will prepare a program and translate medical documents. You will not have to repeat the previously performed diagnostic procedures.
  • We will keep in touch with the hospital after treatment in Europe.
  • We will organize additional diagnostic examinations and treatment in a European hospital, if required.
  • We will buy medicines abroad and forward them to your native country. 

The best specialists in the world will take care of your health. The Booking Health employees will help to reduce the cost of treatment, organize the trip, and you will be able to fully focus on restoring your health.

Authors: Dr. Vadim ZhiliukDr. Sergey Pashchenko




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