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Pericarditis

Topic Overview

The heart

What is pericarditis?

Pericarditis is swelling and irritation of the pericardium, which is the sac that surrounds your heart.

Pericarditis usually doesn't cause serious problems. Most people get better in 7 to 10 days. When there are problems, they may include:

  • A buildup of fluid in the pericardial sac (pericardial effusion).
  • Sudden pressure on the heart and sudden difficulty pumping enough blood (called cardiac tamponade). This can be caused by the weight and pressure of the fluid buildup if it happens quickly.
  • Constrictive pericarditis, which can occur when pericarditis comes back or becomes a longer-term problem. The sac around the heart gets thick and stiff. This makes it harder for the heart to pump blood.

What causes pericarditis?

Many things can cause pericarditis, including:

  • Viral infection. This is the most common cause.
  • Heart attack.
  • Chest injury.
  • Recent heart surgery.
  • Certain diseases, such as HIV, lupus, hypothyroidism, kidney disease, or tuberculosis.
  • Medicine side effects, including cancer treatments.

In many cases, the cause is not known.

What are the symptoms?

The main symptom is a sharp pain in the center or left side of your chest. The pain may spread to the shoulder blade. For some people, this pain is dull instead of sharp. It may be worse when you lie down or take a deep breath.

The pain lasts for hours or days and doesn't get better when you rest. It's different from a type of chest pain called angina, which only lasts a short time and usually gets better with rest.

Other symptoms may include a mild fever, weakness, feeling very tired, coughing, hiccups, and muscle aches.

Pericarditis usually isn't dangerous. But your chest pain could be caused by something more serious, like a heart attack. Getting diagnosed and treated early can help keep pericarditis from leading to other problems. That's why you should call a doctor right away if you have any kind of sudden chest pain.

How is pericarditis diagnosed?

Your doctor will listen to your heart during a physical exam. He or she will also ask questions about your medical history, such as whether you've had a recent illness, radiation treatment for cancer, or tuberculosis.

Your doctor may want you to have some tests, including an electrocardiogram, a chest X-ray, and blood tests.

If the chest X-ray shows any fluid buildup, or if you have new or worse symptoms, such as shortness of breath, your doctor may want you to have a test called an echocardiogram.

How is it treated?

If there are no other problems, pericarditis usually goes away on its own in a few weeks. During this time:

  • Try aspirin, ibuprofen, or another nonsteroidal anti-inflammatory drug (NSAID) to reduce pain. In some cases, your doctor may prescribe stronger medicine. Be safe with medicines. Read and follow all instructions on the label.
  • Get plenty of rest. Avoid all strenuous activity that has not been approved by your doctor.
  • Follow your doctor's advice about what problems to watch for, such as shortness of breath or other signs of complications.

Be sure to keep all follow-up appointments with your doctor. If you have complications or the illness gets worse, you may need further treatment. This could include medicines or a procedure to relieve the fluid and pressure around your heart (pericardiocentesis).

Other Places To Get Help

Organizations

American College of Cardiology: CardioSmart
Web Address: www.cardiosmart.org

American Heart Association (AHA)
Web Address: www.heart.org

Related Information

References

Other Works Consulted

  • Hoit BD (2011). Pericardial disease. In V Fuster et al., eds., Hurst's the Heart, 13th ed., vol. 2, pp. 1917–1939. New York: McGraw-Hill.
  • LeWinter MM, Tischler MD (2012). Pericardial diseases. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 2, pp. 1651–1671. Philadelphia: Saunders.
  • Maisch B, et al. (2004). Guidelines on the diagnosis and management of pericardial diseases. Executive summary. European Heart Journal, 25(7): 587–610.
  • Welch TD, et al. (2012). Diseases of the pericardium, cardiac tumors, and cardiac trauma. In EG Nabel, ed., ACP Medicine, section 4, chap. 16. Hamilton, ON: BC Decker.

Credits

By Healthwise Staff
Primary Medical Reviewer Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical Reviewer Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
Current as of March 12, 2014

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