YOUR HEALTH

DEAR DR. DONOHUE: My son is 18. He plays football and basketball. Two weeks ago he started having chest pains. I took him to a doctor who thought he had costochondritis. He didn't get better. I took him to another doctor, who ordered X-rays. Within 30 minutes of the X-ray, we were told his heart looked enlarged. He was admitted to the hospital, and the doctor there had an echocardiogram taken. He had fluid around his heart and pericarditis. He was put on prednisone. A follow up echo showed the fluid to be drying up. What are his chances of it coming back? Does he have permanent heart disease? He wants to play basketball in college. Will he be able to do that? -C.M.

ANSWER: Your son should be able to return to his athletic life without any restrictions. He does not have permanent heart disease.

Pericarditis is an inflammation of the pericardium. That's a two-layered sac that encloses the heart. The two layers make it look a little like a woman's handbag, with an outside coat and an inner lining. The pericardium holds the heart in place. The inflammation can happen at any age, but it most often strikes young adults.

Viruses, bacteria, a sluggish thyroid gland and rheumatic fever are all possible causes, but viruses are the most frequent ones.

Pericarditis causes pain -often severe and most often located on the left side of the chest. It worsens when the person lies down and lessens upon sitting and leaning forward. Sometimes the inflammation also leads to an outpouring of fluid between the two layers of the pericardium. That's a pericardial effusion.

Aspirin, indomethacin and prednisone can ease the inflammation. Most patients return to a vigorous life after the inflammation has completely subsided. A few have a relapse, but that, too, can be treated if it happens.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.