Pericarditis with PMR and Scleroderma

Posted by gila @gila, Feb 28 7:30am

I had a CT angiogram with contrast yesterday due to chest pain with radiation to left shoulder, back and shortness of breath x 2 weeks and two ER visits. Echocardiogram was negative. Cardiologist says it is pericarditis and are treating me with Metoprolol 25 mg and colchicine 0.6 mg daily. Prior to the CT I took the two prescribed tablets to lower my pulse rate below 60 and was running at 52 beats per minute and steady. They gave me a nitroglycerin tablet also. When they injected the dye for the CT, my heart rate became very erratic. The nurse said “your heart went crazy”. (Very unprofessional and really not helpful.) They injected the dye again with same results. As a result, they said images were not clear enough and the test wasn’t any good.
I have PMR and morphea/scleroderma, both diagnosed in the last 6 months. Also had Covid in January. My primary caregiver has me on prednisone 5mg day. Have an appointment with a rheumatologist March 6th. Hopefully he can pull these things all together to get me feeling better. I have lost 30 pounds and pretty much have felt like I have the flu everyday. Any minimal activity elicits the chest pain. Am wondering if anyone has similar experiences with autoimmune diseases and developed heart problems? If so, what treatment was successful for you?
Thank you

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John, Volunteer Mentor | @johnbishop | Feb 28 8:19am

Hello @gila, I found a couple of posts by @mcgeesdad that mentions being treated with Colchicine for Pericarditis while having PMR that might be helpful to discuss with your rheumatologist. I thought I would share the posts while you wait for other members who may have experience to respond.
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mcgeesdad | @mcgeesdad | Jun 4, 2021 - https://connect.mayoclinic.org/comment/606924/
My initial occurrence of PMR was Sept. 2019 and it lingered in various intensities through mid-July 2020. It remained undiagnosed that entire time. In mid-July on my 70th BD I was sent to ER (Happy Birthday) and was diagnosed with Pericarditis. Stayed at Mayo for 3 days. But on day one the Doctors prescribed for me Colchicine & 40 mg Prednisone. Well that immediately addressed the pain from the Pericarditis as well as completely & simultaneously eliminated all body and muscle stiffness from PMR!
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mcgeesdad | @mcgeesdad | Jun 4, 2021 - https://connect.mayoclinic.org/comment/607036/
From what I understand Colchicine is a medication used to treat gout. The anti-inflammation properties that make it effective against gout, also make it effective in treating Pericarditis. So, believe those same qualities helped with the PMR.
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Mayo Clinic lists Colchicine as one of the treatments for Pericarditis - https://www.mayoclinic.org/diseases-conditions/pericarditis/diagnosis-treatment/drc-20352514

Can you provide an update after your appointment with the rheumatologist?

gila | @gila | Feb 28 9:45am

Thank you, John. I remain hopeful that things can improve. I wonder if the small amount of prednisone I’m receiving is not enough to knock all this inflammation back. The rheumatologist will surely have advice for this.

John, Volunteer Mentor | @johnbishop | Feb 29 7:30am

In reply to @gila "Thank you, John. I remain hopeful that things can improve. I wonder if the small amount..." + (show)

I've had two occurrences of PMR and for both I was started on 20 mg prednisone. It is a great question to ask your rheumatologist at your upcoming appointment. I think I've read that the average starting dose for PMR is 12.5 to 25 mg prednisone but I'm sure there are a lot of factors involved and each of us are different. The concern when you have PMR is the possibility of also having Giant Cell Arteritis (GCA) which can cause loss of vision and more serious problems. If you have any jaw, temple, scalp or head area pain be sure to mention that to your rheumatologist or doctor as GCA normally takes a higher dosage of prednisone or additional treatments.

Can you let us know how your appointment with the rheumatologist goes?

gila | @gila | Feb 29 7:45am

GCA sounds so 😱 scary. My father had PMR and never developed it. I hope and pray I have the same luck.
Right now am so overwhelmed with the uncomfortable and debilitating symptoms from these concurrent diseases. Ugh.
Will definitely post results of my rhuematologist appointment. Thank you.

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