Your heart beats in a fluid-filled sac called the pericardium that keeps it protected while it pumps blood to your body. Inflammation, irritation or swelling of this sac is called pericarditis. It is often caused by a viral infection, but can also be caused due to other things such as a heart attack, chest injury or certain diseases. Although anyone can have this condition, it is most common in men between 20 and 50 years old.
If you have pericarditis, it’s fairly common to develop symptoms suddenly. The main symptom is pain in the center or left side of your chest. The discomfort is from your heart rubbing against the pericardium. You may feel this pain spread to your back, neck or shoulder. You may also find that it’s hard to breathe when you lie down or notice other symptoms like a dry cough or generally feeling weak and tired. Seeking medical care right away is very important if you begin having chest pain.
If you are diagnosed with pericarditis, you will likely be treated with medications for pain and inflammation. Use this condition center to learn more about pericarditis. You can keep up with the latest research, find questions to ask your doctor, and get tips to help you feel your best.
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 the 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. And 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.
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).
Reference: American Academy of Cardiology. https://www.cardiosmart.org/Healthwise/hw16/9330/hw169330