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Pericarditis -- Adult

Definition

Pericarditis is irritation and swelling of the pericardium, which is the thin sac that surrounds the heart. Extra fluid that builds up between the two layers of the pericardium restricts the heart’s action.

Pericarditis
pericarditis
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Causes

The cause of pericarditis is often unknown. However, possible causes include:

Risk Factors

Factors that increase your chance of getting pericarditis include:

  • A weakened immune system that is not able to fight off infections and other diseases
  • Any of the causes listed above

Symptoms

Chest pain is a common symptom of pericarditis, especially over the left side or center of the chest. It sometimes spreads to the neck and left shoulder. It is usually a sharp, stabbing pain. Deep breathing or lying down may worsen the pain. Sitting up may lessen it. Other symptoms may include:

  • Shortness of breath
  • Coughing
  • Fever and chills
  • Pain when swallowing
  • Weakness and fatigue

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. A stethoscope will be used to listen for a grating or rubbing sound in your heart. If the condition is severe, there may be a crackle sound in your lungs. The following tests may be performed:

Images of your heart may need to be taken. This can be done with:

Your bodily fluid may need to be tested. This can be done with:

  • Blood tests
  • Pericardiocentesis

Treatment

Treating pericarditis depends on the cause, if the cause is known. In many cases, when the cause is unknown or viral pericarditis is suspected, pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) are given. In other cases, corticosteroids may be given. Antibiotics are used to treat bacterial infections that cause pericarditis.

If the fluid is seriously affecting the heart’s ability to pump, the fluid may need to be removed through pericardiocentesis, which is the same procedure used for testing. In rare cases, surgery may be performed.

Depending on the cause of the pericarditis, the illness can range from mild to life-threatening. Acute inflammatory pericarditis usually subsides with treatment within a few weeks or months. However, pericarditis caused by chronic inflammatory diseases, like systemic lupus erythematosus or rheumatoid arthritis, may last longer or tend to recur.

Prevention

Pericarditis may be prevented in the future with certain anti-inflammatory medications. Talk to your doctor about whether this is right for you.

Revision Information

  • American Heart Association

    http://www.heart.org

  • National Heart, Lung and Blood Institute

    http://www.nhlbi.nih.gov

  • Canadian Cardiovascular Society

    http://www.ccs.ca

  • The College of Family Physicians of Canada

    http://www.cfpc.ca

  • Acute pericarditis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 3, 2012. Accessed March 25, 2013.

  • 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%5FUCM%5F444931%5FArticle.jsp. Updated February 27, 2013. Accessed March 25, 2013.

  • 11/4/2013 DynaMed's Systematic Literature Surveillance. Available at: http://dynamed.ebscohost.com/about/about-us : Imazio M, Brucato A, et al. A randomized trial of colchicine for acute pericarditis. N Engl J Med. 2013 Oct 17; 369(16):1522-1528.