Pericarditis is irritation and swelling of the sac that surrounds the heart. The sac, called the pericardium, is made up of two thin layers and a small amount of fluid that sits between the layers. Since the sac surrounds the heart, swelling of the sac can make it difficult for the heart to work properly.
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The cause of pericarditis is often unknown. Potential causes include: Viral, bacterial, or fungal infection—most common known causeHeart attack
Inflammatory diseases such as
systemic lupus erythematosusCancer that has spread from a tumor near the heartKidney failureInjury or surgery affecting the chest, esophagus, or heartRadiation
Certain medications used to suppress the immune system
A weakened immune system may increase your chance of pericarditis.
A common symptom of pericarditis is a sharp, stabbing chest pain. The pain is often over the left side or center of the chest and may spread to the neck and shoulders. Deep breathing or lying down may worsen the pain and sitting up may lessen it.
Other symptoms may include: Shortness of breathCoughingFever and chillsPain when swallowingWeakness and fatigueFeeling abnormal heartbeats
The doctor will ask about your pain, other symptoms, and medical history. A physical exam will be done including listening to the heart or lungs for abnormal sounds. The swollen layers can rub against the heart and create a unique sound that can be heard with a stethoscope. To confirm the diagnosis and determine the severity of the condition, images of the heart and chest may be taken with: Chest x-ray—includes images of the lungElectrocardiogram
(EKG)—shows the electrical activity of the heart
Echocardiogram—shows how well the heart muscle is working
CT scan—detailed images of tissue in the chest
Bodily fluids may also need to be tested to look for infections. Fluids may be found through: Blood testsPericardiocentesis—fluid from around the heart is removed for testing
The main goals of treatment are to relieve pain and swelling and treat any underlying causes. If an infection is present an antibiotic or other medication may be recommended.
Rest, over-the-counter pain medications, and monitoring may be all that is needed for mild pericarditis. The inflammation usually passes within a few weeks or months.
Pericarditis can also be an emergency situation. More severe pericarditis may need advance treatment and hospitalization to manage complications. If the swelling is making it difficult for the heart to beat, fluid may need to be removed. A procedure called pericardiocentesis removes the fluid with a needle. In rare cases, surgery may be done to open the sac to relieve pressure on the heart.
Some types of pericarditis are caused by chronic inflammatory diseases, like systemic lupus erythematosus or
rheumatoid arthritis. These forms of pericarditis may last longer or tend to recur. A treatment plan will be created to help decrease the risk of future incidents.
There is no known way of preventing acute pericarditis.
Pericarditis. Texas Heart Institute website. Available at
http://www.texasheart.org/HIC/Topics/Cond/pericard.cfm. Updated October 2012. Accessed March 25, 2013.
What is pericarditis? American Heart Association website. Available at
http://www.heart.org/HEARTORG/Conditions/More/What-is-Pericarditis_UCM_444931_Article.jsp. Updated February 27, 2013. Accessed March 25, 2013.
Last reviewed December 2016 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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