Definition
Pericarditis is a problem of the sac around the heart. The sac has two layers with a layer of fluid in between them. Pericarditis is swelling and inflammation of this sac. It makes it hard for the heart to work as it should.
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Causes
The cause of pericarditis is often unknown. Some potential causes include:
- Viral, bacterial, or fungal infection—most common known cause
- Heart attack
- Inflammatory diseases such as rheumatoid arthritis or systemic lupus erythematosus
- Cancer that has spread from a tumor near the heart
- Kidney failure
- Injury or surgery affecting the chest, esophagus, or heart
- Radiation therapy
- Certain medications used to suppress the immune system
Symptoms
Chest pain is a common symptom. The chest pain may be:
- Sharp or stabbing
- Over the left side or center of the chest
- Spread to the neck and shoulders
- Worsen by deep breathing or lying down
- Improve with sitting up
Other symptoms may include:
- Shortness of breath
- Coughing
- Fever and chills
- Pain when swallowing
- Weakness and fatigue
- Feeling abnormal heartbeats
Diagnosis
The doctor will ask about your pain. You will also be asked about your health past. An exam will also be done. The doctor will listen for abnormal sounds in the heart or lung.
Swollen layers of the sac can rub against the heart. It makes a unique sound that can be heard with a stethoscope. Images of the heart and chest will confirm the diagnosis. They may be taken with:
- Chest x-ray
- ECG —shows the electrical activity of the heart
- Echocardiogram —shows how well the heart muscle is working
- MRI scan or CT scan —detailed images of tissue in the chest
Other tests may be needed to find the cause. Tests may include:
- Blood tests
- Pericardiocentesis—test of fluid around the heart
Treatment
The main goal is to relieve pain and swelling. If a cause is known, it will be treated as well.
Mild swelling will often pass in a few weeks or month. Care may include:
- Rest
- NSAID medicine to reduce swelling
- Follow up with your doctor to check on progress
Severe swelling can be an emergency. It may make it hard for the heart to beat. Hospital care may be needed. Treatment may include:
- Removing fluid from the heart sac. The fluid is removed with a needle.
- Surgery to open the sac. This will relieve pressure on the heart. This is a rare option.
Other inflammatory diseases increase the risk of pericarditis. It may last longer or tend to recur. A treatment plan will be made to help decrease the risk of more problems.
RESOURCES
American Heart Association http://www.heart.org
National Heart, Lung, and Blood Institute https://www.nhlbi.nih.gov
CANADIAN RESOURCES
Health Canada https://www.canada.ca
Heart and Stroke Foundation of Canada http://www.heartandstroke.ca
References
Acute and recurrent pericarditis. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T115401/Acute-and-recurrent-pericarditis . Updated March 5, 2018. Accessed August 30, 2018.
What is pericarditis? American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/What-is-Pericarditis%5FUCM%5F444931%5FArticle.jsp#.WiAwZlWnFQI. Updated July 5, 2017. Accessed August 30, 2018.
11/4/2013 DynaMed Plus Systematic Literature Surveillance. Available at: https://www.dynamed.com/topics/dmp~AN~T115401/Acute-and-recurrent-pericarditis : Imazio M, Brucato A, et al. A randomized trial of colchicine for acute pericarditis. N Engl J Med. 2013;369(16):1522-1528.
Revision Information
- Reviewer: EBSCO Medical Review Board Michael J. Fucci, DO, FACC
- Review Date: 11/2018
- Update Date: 08/30/2018