Viral Rash: Types, Symptoms, and Treatment in Adults and Babies
Can COVID-19 Trigger Pericarditis?
COVID-19 can trigger pericarditis, a type of heart inflammation, but this is quite rare. Symptoms include chest pain that comes on quickly or worsens when you breathe deeply or lie down.
Pericarditis occurs when the fluid-filled sac surrounding the heart becomes inflamed. This sac, called the pericardium, helps protect and hold the heart in place.
Pericarditis can be acute or recurrent. Recurrent pericarditis is when you have symptoms after at least 4 weeks without them, and it's caused by an autoimmune response.
Acute pericarditis, on the other hand, refers to the first episode, which lasts 4 to 6 weeks or less. There are other types of pericarditis as well, and the cause can be unknown (idiopathic). One known cause is a viral infection.
SARS-CoV-2, the coronavirus that causes COVID-19, is one of the viruses that can trigger pericarditis. Keep reading to learn more.
Sometimes, pericarditis can occur with myocarditis, which is another type of heart inflammation of the heart muscle itself, in people with COVID-19. This is called myopericarditis or perimyocarditis, depending on which one predominates.
Cases of myocarditis and pericarditis have been reported for all variants of the coronavirus so far.
However, information on COVID-19-associated pericarditis and its incidence is lacking compared with myocarditis.
For reference, a 2021 report from the Centers for Disease Control and Prevention (CDC) found that myocarditis occurred in 150 per 100,000 people with COVID-19 compared with 9 per 100,000 people without COVID-19 from March 2020 to January 2021.
A 2023 review of research notes that symptoms of COVID-19-associated pericarditis are similar to those of other forms of viral pericarditis.
The symptoms of pericarditis include:
When to seek medical helpPericarditis can feel like a heart attack. If you have chest pain, especially if it comes on suddenly and doesn't go away, seek immediate medical attention or call 911.
Pericarditis can happen while you're sick with COVID-19 or after you recover.
One 2021 review reports that a diagnosis of pericarditis occurred anywhere from 5–56 days after a COVID-19 diagnosis.
Some studies published in 2021, 2022, and 2023 have also reported pericarditis as a finding in people with long COVID.
Long COVID is a collection of health problems that persist in the weeks, months, or years after you recover from COVID-19.
Having risk factors doesn't mean you'll definitely get pericarditis. Instead, it means you have an increased risk compared with people who don't have risk factors.
Rest and medications that reduce pain and inflammation are typical treatments for pericarditis.
The medications a doctor may prescribe for pericarditis include:
If the COVID-19-associated pericarditis returns (recurrent pericarditis), then your doctor may prescribe IL-1 inhibitors to treat the condition and help reduce the chance of future recurrences.
According to studies from 2021 and 2022, the same types of medication can often treat COVID-19-associated pericarditis.
Can a COVID-19 vaccine trigger pericarditis?
COVID-19 mRNA vaccines rarely trigger pericarditis. In fact, the chances of myocarditis or pericarditis in people ages 5 to 39 after getting vaccinated are:
When it happens, it may be related to the immune response to the vaccine in some people, and it is most likely to happen within a week of vaccination. According to the CDC, adolescent and young adult males are most likely affected.
The benefits of COVID-19 vaccination outweigh the risksOverall, the benefits of COVID-19 vaccination outweigh the risks of pericarditis.
In fact, researchers have found you're actually more likely to develop pericarditis after getting COVID-19 than after getting vaccinated.
What are the symptoms of COVID-19 heart damage?
Besides pericarditis and myocarditis, COVID-19 can affect the heart by leading to infection, inflammation, low oxygen levels, blood clots, and stress cardiomyopathy. Depending on the specific damage, symptoms may include abnormal heartbeat, shortness of breath, swelling, and more.
How long after COVID-19 do you get myocarditis?
Myocarditis typically develops within about a year of having COVID-19.
Can COVID-19 make PVC worse?
COVID-19 can trigger heart problems like premature ventricular contractions (PVC) and could, therefore, theoretically, make any existing problems worse.
COVID-19 can trigger pericarditis in some people. However, it's not very common. The symptoms of COVID-19-associated pericarditis are similar to those of pericarditis caused by other viruses.
While pericarditis can affect anyone, the people who most often develop it are younger and male. Rest and medications can typically treat it and ease inflammation and pain.
In rare cases, COVID-19 mRNA vaccines may trigger pericarditis. However, it's more likely that you'll develop pericarditis from COVID-19 than from COVID-19 vaccination. Overall, the benefits of the COVID-19 vaccines outweigh their risks.
All About Pericarditis
Pericarditis is inflammation of the lining around the heart that can cause pain and is often caused by a viral infection. It can be treated with anti-inflammatory medication and rest, but more severe cases may require further treatment to prevent recurrence.
The pericardium helps keep your heart in place inside the chest wall, provides lubrication for the heart, and shields it from infection and other types of harm. Its layers have a small amount of fluid between them to prevent friction when the heart beats. When these inflame, they rub against each other, which can result in chest pain.
The cause of pericarditis is often unknown, in which case it's referred to as idiopathic pericarditis. That said, viral infections are likely responsible for many cases.
The incidence of pericarditis is slightly higher in the African American population, but anyone can get the condition.
Pericarditis shouldn't be confused with myocarditis, which affects the heart muscle itself. Read on to learn more about pericarditis, its types, causes, symptoms, treatment, and more.
Your first episode, called acute pericarditis, typically lasts less than 4-6 weeks. It may occur on its own or as a symptom of an underlying disease.
But you can also develop recurrent pericarditis if your symptoms return after at least 4 weeks without them. This is caused by your immune system mistakenly attacking the pericardium. Even if you don't have symptoms between episodes, the inflammation may still be present.
For those with multiple recurrences, full recovery can take up to 5 to 7 years. Up to 30 percent of people with a first episode of acute pericarditis will experience a recurrence within 18 months of their initial episodes or relapses of the condition.
About 85% to 90% of people with pericarditis have chest pain as a symptom.
Some people may think they are having a heart attack, with a sharp or stabbing pain in their chest that comes on suddenly. The pain from pericarditis is typically sharp and may worsen as you take deep breaths. Lying down may also intensify the pain, while sitting up and leaning forward could offer some relief.
Pericarditis pain may radiate to your shoulders, neck, arms, or jaw.
Your symptoms may worsen when you:
If the cause of your pericarditis is bacterial, you may have additional symptoms of fever, chills, and an above-normal white cell count. If the cause is viral, you may experience upper respiratory symptoms like cough, runny nose, or congestion. It may also feel like flu-like or stomach symptoms. These symptoms aren't necessarily specific to these types of pericarditis.
Your symptoms may vary depending on the type of pericarditis you have. When you have sharp chest pain, it's best to seek medical help right away.
Should I go to the ER for pericarditis?
Because pericarditis can feel like a heart attack, it's important to go to the ER right away for treatment.
Recurrent pericarditis is an autoinflammatory disease, but viruses are presumed to be the most common cause of other types of pericarditis in developed countries. This could be due to the virus itself or the body's immune response to a virus.
Other infectious causes include:
Noninfectious causes of other types include:
When doctors can't identify a cause, they'll diagnose you with idiopathic pericarditis.
Treatment for pericarditis will depend on its underlying cause but generally aims to reduce your pain and inflammation and minimize the chance of recurrence.
If you have a bacterial infection, a doctor may prescribe antibiotics. Other treatments may include:
For acute pericarditis, a doctor may start with anti-inflammatories like NSAIDs and colchicine. If episodes repeat, they may switch to IL-inhibitors and corticosteroids.
Does pericarditis go away on its own?
In most cases, pericarditis is mild and will clear up on its own with simple treatment, like anti-inflammatory medications and rest. That said, if you have other medical risks, your doctor may initially treat you in the hospital.
Your doctor will ask about your medical history, what your symptoms were when your symptoms began, and what seems to make them worse. They'll also perform a physical exam.
Inflammation of the pericardium can increase fluid between the two layers of tissue in the sac, resulting in effusion. The doctor will listen with a stethoscope for signs of excess fluid.
They'll also listen for a pericardial rub, the noise of your pericardium rubbing against the outer layer of your heart.
There's no conclusive way to prevent pericarditis, especially viral pericarditis. But if you experience pericarditis, following your treatment plan, using colchicine, and avoiding corticosteroids may reduce the chance of it recurring.
Until you fully recover, rest and avoid strenuous physical activity. Discuss with your doctor how long you should limit your activity.
If you see any signs of recurrence, check with your doctor as soon as possible.
Recovery from pericarditis takes time. It may take weeks for symptoms to completely resolve in some cases.
Most cases of pericarditis are mild and without complications. However, there can be complications with chronic pericarditis, including fluid buildup and constriction or scarring of the pericardium.
Treatments for these complications are available, including surgery. Research about medical treatment options is ongoing.
If pericarditis becomes chronic, you may need to continue taking NSAIDs or other drugs. Full recovery can take up to 5 to 7 years for those with multiple recurrences. Interleukin-1 inhibitors may prevent flares of your pericarditis from coming back again.
Seek help right away if you have any type of chest pain, as it can be a sign of something more serious.
EXCLUSIVE: What Has HHS Withheld On COVID-19 Vax? Sen. Ron Johnson Is About To Find Out
FIRST ON THE DAILY SIGNAL—A new letter from Sen. Ron Johnson, R-Wis., puts federal health agencies on notice that he plans to subpoena unredacted records withheld by the Biden administration on potential adverse effects of the COVID-19 vaccines.
"It appears that even in the waning days of the Biden administration, your agencies will remain defiant in providing the public with complete information about the COVID-19 vaccines," writes Johnson, incoming chairman of the Senate's Permanent Select Subcommittee on Investigations, in the Dec. 5 letter shared with The Daily Signal.
"If it becomes necessary to subpoena these and other requested records in the next Congress when I become chairman of the Permanent Subcommittee on Investigations, I will do so," the Wisconsin Republican adds.
Johnson's letter went to Health and Human Services Secretary Xavier Becerra; Food and Drug Administration Commissioner Robert Califf; and Centers for Disease Control and Prevention Director Dr. Mandy Cohen. (CDC and FDA are agencies within the Department of Health and Human Services.)
All three public health officials likely will be replaced shortly after President-elect Donald Trump takes office.
In 2021, the Israeli Ministry of Health requested data from officials with the CDC and FDA about adverse reactions to COVID-19 vaccines. Israeli health officials cited their concerns about heart conditions, myocarditis, and pericarditis in individuals who got a shot.
However, government documents released on the matter have been heavily redacted.
"As a result of your agencies' excessive redactions and incomplete productions, the complete account of how your agencies reviewed and analyzed the concerning health information from the Israeli Ministry of Health remains unclear," Johnson writes in his letter to the HHS, CDC, and FDA officials.
The senator requested unredacted documents regarding the Israeli officials' concerns as well as data on the COVID-19 vaccines.
"Your agencies' lack of transparency is unacceptable," Johnson tells the three Biden administration officials in the letter. "The public deserves the complete truth about your agencies' awareness of and lack of response to the glaring health risks associated with the COVID-19 vaccines."
Johnson's nine-page letter includes images of records and over 40 pages of enclosures demonstrating the heavily redacted documents he seeks information about.
After Republicans won a majority in the Senate in the Nov. 5 election, Johnson wrote to request that the three public health agencies produce other documents by Dec. 3. The agencies ignored his Nov. 19 request, perhaps because Johnson was still a ranking GOP member in the Democratic majority and not a chairman with the authority to compel production of records.
Spokespersons from the HHS, CDC, and FDA did not respond to inquiries from The Daily Signal for this story.
Johnson's Dec. 5 letter includes a detailed timeline noting on Feb. 28, 2021, that CDC and FDA officials were notified about a request from the Israeli Ministry of Health for reports of young people contracting myocarditis after receiving Pfizer's COVID-19 vaccine.
On March 3, 2021, less than two months after President Joe Biden was sworn in, the Israeli Ministry of Health notified CDC again about reports of "a large number of myocarditis and pericarditis cases in young individuals." The age range later was specified to be 16 to 30.
A memo dated March 10, 2021, from Dr. Tom Shimabukuro, a member of the Biden administration's COVID-19 Vaccine Task Force, says: "The [Israeli] Ministry of Health stated they received reports of around 40 cases of this adverse event. They did not provide additional details about these cases."
The CDC's March 10 response to Israel's health officials says adverse conditions were found in only an "estimated 0.7 per million doses of vaccine administered."
But, the CDC response notes, "limitations of passive surveillance such as under-reporting, lack of a control group, [and] missing and incomplete data make it challenging to assess causation."
By April 2021, the Israeli Ministry of Health had sent slides to the CDC and FDA, stating that "by the end of March 2021, 5.2 million Israelis received the first dose of the vaccine and 4.8 million received a second dose."
The Israeli agency added: "The incidence of myocarditis following dose 1 was 1.1 per million, and 11.7 per million following dose 2—a 964% increase in incidence between the two."
The Permanent Select Subcommittee on Investigations, which Johnson is expected to chair when the new Republican majority takes over Jan. 3, is part of the Senate Homeland and Governmental Affairs Committee.
Any member of Congress may request documents from an executive branch agency, but only a committee or subcommittee majority has the subpoena power to compel the production of information.
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