Pericarditis

Learning that you have pericarditis can leave you with many questions about what’s happening. Our heart experts will explain your condition and work with you to plan treatment that meets your needs.

What is pericarditis?

Your heart is surrounded by a protective sac or membrane called the pericardium. Pericarditis, or pericardial disease, is swelling or irritation of this membrane.

Pericarditis is often a mild condition that is easily treated with rest or other simple treatments. Or it can occur repeatedly over many years.

It’s important to treat pericarditis right away. Immediate treatment can rule out other conditions, such as a heart attack. Treating pericarditis' underlying cause can also reduce the risk of long-term effects.

Complications of pericarditis

Chronic inflammation of the pericardium can cause scarring and thickening, leading to a serious complication known as constrictive pericarditis. This change keeps the heart from expanding as it fills with blood, causing heart failure symptoms.

Cardiac tamponade is another serious complication that can happen with pericarditis. When the pericardium is inflamed, it develops more fluid between its two layers. In cardiac tamponade, there is too much fluid, putting pressure on the heart and causing your blood pressure to become very low.

Rarely, complications of pericarditis can be life-threatening – causing abnormal heart rhythms and even death.

Pericarditis symptoms

The primary pericarditis symptom is sharp, stabbing chest pain. If the chest pain feels like a heart attack, call 911.

You may find that:

• The pain comes on quickly, in the middle or left side of your chest
• Pain may extend into your shoulders, neck or back
• Chest pain may ease when sitting up and leaning forward
• Pain might worsen when lying down

Other pericarditis symptoms

You may also experience pericarditis symptoms such as these:

• Low-grade fever
• Weakness
• Heart palpitations, the feeling that your heartbeat is fast or fluttering
• Trouble breathing, especially when lying down
• Dry cough
• Swelling in your abdomen or legs

What causes pericarditis?

Pericarditis symptoms can happen at any age, but males ages 20 to 50 are more likely to develop it.

The cause of pericarditis is often unknown. However, some factors are known to contribute to pericarditis, such as:

• A past heart attack
• Previous heart surgery
• Autoimmune diseases
• Trauma or injury from an accident
• Certain bacterial, viral and fungal infections
• Kidney failure
• HIV/AIDS
• Tumors
• Cancer
• Radiation therapy

Rarely, pericarditis may be triggered by certain medications such as phenytoin, procainamide, warfarin or heparin.

Pericarditis diagnosis

To diagnose pericarditis, we’ll start with a thorough physical exam and ask about your medical history – including your pericarditis symptoms. We may order diagnostic tests for you, such as:

• Radiographic imaging, including chest X-ray, CT scan or cardiac MRI to see pictures of your heart and chest
  
• Echocardiogram, or heart ultrasound, that shows your heart’s size and motion
  
• Electrocardiogram (EKG) to check your heart’s electrical activity
  
• Laboratory testing to check your blood for signs of infection

With our nationally renowned expertise and technology, we can quickly and precisely diagnose your condition so you can feel better fast. Find out more about our heart and vascular testing and diagnosis.

Pericarditis treatment

Most of the time pericarditis is mild and clears up fairly easily. To treat pericarditis, we may recommend rest and medication, such as aspirin or ibuprofen for pain and inflammation, or an antibiotic or antifungal prescription for infection.

If pericarditis doesn’t heal or is more advanced, you may need other treatment. We may recommend:

• Intravenous or oral steroids
• Other anti-inflammatory medications
• Diuretics, or water pills (used to help your body get rid of excess fluid)
• Pericardiocentesis, where we guide a thin tube called a catheter to the heart to remove fluid from the pericardium, the sac that surrounds the heart

If you develop extremely severe pericarditis and other treatments don’t work, we may recommend pericardectomy – a procedure to remove the pericardium entirely.