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Pericarditis with presence of friction rub and fatigue - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Hypertension and Heart Disease
Answered by

General & Family Physician
Practicing since : 2009
Answered : 667 Questions
Doctor :   Hi
Doctor :  
How can i help you?
User :   Hi, I was diagnosed with pericarditis last August d/t the presence of a friction rub. Chest pain was not present. Echocardiography, EKG, and blood tests did not reveal anything significant. The friction rub has since persisted to this day (I am a nurse, so am able to hear it with my stethoscope). I always feel fatigued and my activity tolerance is poor, but am otherwise asymptomatic. The cardiologist that reviewed my case in August determined that a mycobacterial sepsis I had earlier that summer was likely the cause. So my question is, should I be concerned about a friction rub that doesn't leave? Could it be related to my feelings of fatigue and activity intolerance? Am I at risk for developing constrictive pericarditis? Should I be on anti-inflammatories? Any advice would be appreciated. Thanks!
Doctor :  
Let me read through the paragraph.
User :   Thanks.
User :   I am 20 years old, so do not want to risk any permanent cardiac problems
Doctor :  
May i know your age and gender?
User :   Female, 20 yo
Doctor :  
SInce when have you been having the symptoms of fatiguability?
Doctor :  
Do you have any breathing difficulties?
User :   since my initial diagnosis of atypical mycobacterial sepsis last spring
User :   No breathing difficulties
Doctor :  
Doctor :  
When was the last ECHO cardiogram done?
User :   August
Doctor :   Ok.
Doctor :  
I shall brief you about it.
User :   Good
Doctor :  
Since you do not have any symptoms and since the reports are not all normal
Doctor :  
you may not need the treatment right now
Doctor :  
the fatiguability you are experiencing may not be the signs of the pericarditis
Doctor :   since there are no other symptoms such as chest pain, cough or breathlessness
Doctor :   However if you develop any such symptoms or if the scan show any changes then you may be on the treatment.
Doctor :  
It is difficult to predict the severity of the illness based on the rub alone
Doctor :   have you followed?
User :   Yes. So chronic inflammation should not necessarily produce complications of pericardial thickening?
Doctor :   A friction rub is seen if there is some amount of pericardial thickening
Doctor :  
so if you are hearing a rub then there might be a pericardial thickening
User :   Would it be wise to take anti-inflammatories to prevent further damage from inflammation?
Doctor :  
but if the thickening is mild and you do not have symptoms you may not need treatment
Doctor :   Have you been examined by a doctor recently?
User :   No
Doctor :   Ok.
Doctor :   I would suggest you to get a physical examination by a doctor
Doctor :  
not questioning your decision
Doctor :  
but just let a doctor examine you for the rub
Doctor :  
he would be able to take a decision if the rub is severe
Doctor :  
and if you need a antiinflammatory drugs
Doctor :  
this is only suggested because
Doctor :  
chronic usage of antii inflammatory may cause complications
Doctor :  
of its own
Doctor :  
Have you followed?
Doctor :  
and it would be unfair just to start the medications and to develop the sideeffects, if you do not need them
User :   Yes. This makes sense.
Doctor :   Do you have any other query?
User :   No. Thank you for your time!
Doctor :  
You have asked for a second opinion from one of the cardiologist.
Doctor :  
he shall be giving an opinion regarding this soon within 24 to 48hrs time.
User :   Very good.
Doctor :   Do you have any other query that you need me to answer?
User :   No. That is all. Thank you very much.
Doctor :  
please fill the feed back form too.
Doctor :  
Thanks for consulting HealthcareMagic. Bye for now. Please refer your friends to our service.
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