Pericarditis is an inflammation (irritation and swelling) of the pericardium, the thin sac that surrounds the heart. Extra fluid that builds up between the two layers of the pericardium restricts the heart’s action.
The cause of pericarditis is often unknown. However, possible causes include:
- Viral, bacterial, or fungal infection
- Heart attack]]>
- Inflammatory diseases such as ]]>rheumatoid arthritis]]> or ]]>lupus]]>
- Cancer that has spread from a tumor near the heart
- ]]>Kidney failure]]>
- Injury or surgery affecting the chest, esophagus (food pipe), or heart
- ]]>Radiation]]> treatment
- Certain medications used to suppress the immune system
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for pericarditis include:
- Weakened immune system that is not able to fight off infections and other diseases
- Any of the causes listed above
Chest pain is a common symptom of pericarditis, especially over the left side or center of the chest. It sometimes spreads to the neck and left shoulder. It is usually a sharp, stabbing pain. Deep breathing or lying down may worsen the pain. Sitting up may lessen it. Other symptoms may include:
- Shortness of breath
- Fever and chills
- Pain when swallowing
- Weakness and fatigue
The doctor will ask about your symptoms and medical history and perform a physical exam. A stethoscope will be used to listen for a grating or rubbing sound in your heart. If the condition is severe, there may be a crackle sound in your lungs. The following tests may be performed:
- Chest x-ray]]> —to show heart size and buildup of fluid
- ]]>Electrocardiograph]]> (ECG or EKG)—to show electrical activity of the heart
- ]]>Echocardiogram]]> —to show heart wall motion, heart size, and buildup of fluid
- Blood tests—to help determine causes
- Pericardiocentesis—drawing a sample of the fluid in the pericardium using a needle to test the fluid for infections
- Heart or chest ]]>MRI]]> or ]]>CT scan]]> —to obtain more detailed images if needed
Treating pericarditis depends on the cause, if the cause is known. In many cases, when the cause is unknown or viral pericarditis is suspected, pain relievers and anti-inflammatory medications are given. In other cases, corticosteroids may be given. If the condition is caused by a bacterial infection, antibiotics are used.
If the fluid is seriously affecting the heart’s pumping, the fluid may need to be removed through pericardiocentesis (the same procedure used for testing). In rare cases, surgery may be performed.
Depending on the cause of the pericarditis, the illness can range from mild to life-threatening. Acute inflammatory pericarditis usually subsides with treatment within a few weeks or months. However, pericarditis caused by chronic inflammatory diseases, like lupus or rheumatoid arthritis, may last longer or tend to recur.
If you are diagnosed with pericarditis, follow your doctor's instructions .
American Heart Association
National Heart, Lung and Blood Institute
Canadian Cardiovascular Society
Canadian Family Physician
Pericardium and Pericarditis. American Heart Association website. Available at http://www.americanheart.org . Accessed August 4, 2003.
Pericarditis. Dr. Community Health Care Wausau Hospital website. Available at http://www.chclibrary.org/ . Accessed August 5, 2003.
Pericarditis. Heart Center Online website. Available at http://www.heartcenteronline.com . Accessed October 3, 2003.
Pericarditis. Texas Heart Institute website. Available at http://www.tmc.edu/thi/pericard.html . Accessed August 5, 2003.
Last reviewed November 2008 by ]]>Michael J. Fucci, DO]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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