Tuberculous pericarditis occurs when tuberculosis spreads to the area surrounding your heart. It can cause symptoms like chest pain and lead to life threatening complications. Prompt treatment is essential.
Tuberculosis (TB) is a bacterial infection caused by Mycobacterium tuberculosis (M. tuberculosis). TB remains one of the
While TB most often affects the lungs, it can spread to other tissues, including the heart. About
Read on to learn more about this condition, including symptoms, risk factors, and treatment options.
Tuberculous pericarditis often starts with
The main symptom is chest pain that might:
- feel sharp or stabbing
- spread to your abdomen, arms, or shoulders
- feel worse when you breathe in deeply, cough, or swallow
- feel worse when you lie on your left side
- get better when you lean forward
Other symptoms include:
Most but not all people with tuberculous pericarditis also have respiratory symptoms that can include:
The same bacteria that cause pulmonary (lung) TB cause tuberculous pericarditis. Transmission of M. tuberculosis occurs when you breathe in the respiratory air droplets of someone with the infection.
TB infection of other body parts is called extrapulmonary TB. Tuberculous pericarditis is a rare type of extrapulmonary TB.
Your risk of TB infection spreading to your pericardium is higher if you have a weakened immune system. HIV is perhaps the most significant risk factor for tuberculous pericarditis, especially in regions like Southern Africa, where both conditions are endemic.
- coming into close contact with somebody with TB
- visiting or moving from a country with high rates of TB
- working or residing in areas with a high risk of exposure, such as:
- homeless shelters
- correctional facilities
- having a condition that weakens your immune system, such as:
- receiving an organ transplant
According to the Centers for Disease Control and Prevention (CDC),
In the CDC data, TB was most common in people over the age of 65 years. However, children may be
To diagnose tuberculous pericarditis, a doctor will first consider your symptoms and your personal and family medical history. They may also perform the following:
- physical exam to check your:
- oxygen saturation
- body temperature
- heart rate
- breathing rate
- blood pressure
- electrocardiogram to measure heart function
- imaging such as:
- transthoracic echocardiography
A doctor can confirm the infection with a biopsy, in which they will take a sample of your pericardial fluid with a long, thin needle and perform laboratory tests to look for signs of the bacteria.
Treatment for tuberculous pericarditis has three goals:
- eliminating and controlling the spread of bacteria
- relieving pressure from fluid buildup around your heart
- preventing remodeling of the heart that can cause constrictive pericarditis, which is a thickening and tightening of the sac around your heart
Doctors usually prescribe antibiotics for 6–12 months to eliminate M. tuberculosis. The most common drug combination includes:
A doctor may also need to remove fluid from your pericardium using a procedure called pericardiocentesis. This involves using imaging to guide a thin needle to drain the fluid.
If complications like constrictive pericarditis occur, a doctor may need to perform a pericardiectomy. This involves removing all or part of the pericardium to relieve pressure on your heart.
Without prompt treatment, tuberculous pericarditis can lead to
- pericardial fibrosis (scarring)
- pressure on your heart (cardiac tamponade)
- constrictive pericarditis
Tuberculous pericarditis can be life threatening, especially if you don’t receive prompt medical attention.
Having HIV can worsen your outlook with tuberculous pericarditis. Research from 2008 found that
Your outlook may also be worse if you require a pericardiectomy, which has a mortality rate of up to
Here are some frequently asked questions people have about tuberculous pericarditis.
Is tuberculous pericarditis contagious?
Generally, people with TB outside of their lungs don’t transmit the infection. However, you can still potentially transmit TB if you also have respiratory symptoms.
What is the mortality rate for tuberculous pericarditis?
The death rate for tuberculous pericarditis is high. Older research suggests a 6-month mortality rate of
How can I prevent tuberculous pericarditis if I have TB?
Early diagnosis and treatment of active TB can potentially help reduce the spread of bacteria to other parts of your body. Doctors usually prescribe medications to kill the bacteria.
Most people with TB have respiratory symptoms, but less than
Tuberculous pericarditis is a medical emergency that requires immediate attention to avoid life threatening complications. Treatment usually involves taking medications for more than 6 months to kill the bacteria.