Navigate Up
Unable to display this Web Part. To troubleshoot the problem, open this Web page in a Microsoft SharePoint Foundation-compatible HTML editor such as Microsoft SharePoint Designer. If the problem persists, contact your Web server administrator.


Correlation ID:9b3bf8bf-7fd9-4ad9-8afb-f43ea2e49e10

Print This Page

Pericarditis

Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.

Causes

The cause of pericarditis is unknown or unproven in many cases. It mostly affects men ages 20 - 50.

Pericarditis is often the result of an infection such as:

  • Viral infections that cause a chest cold or pneumonia, such as echovirus or coxsackie virus (common in children) and influenza
  • Infections with bacteria (less common)
  • Some fungal infections (rare)

The condition may be seen with diseases such as:

Other causes include:

  • Heart attack
  • Heart surgery or trauma to the chest, esophagus, or heart
  • Certain medicines, such as procainamide, hydralazine, phenytoin, isoniazid, and some drugs used to treat cancer or suppress the immune system
  • Swelling or inflammation of the heart muscle
  • Radiation therapy to the chest

Symptoms

Chest pain is almost always present. The pain:

  • May be felt in the neck, shoulder, back, or abdomen
  • Often increases with deep breathing and lying flat, and may increase with coughing and swallowing
  • Can feel sharp and stabbing
  • Is often relieved by sitting up and leaning or bending forward

You may have fever, chills, or sweating if the condition is caused by an infection.

Other symptoms may include:

Exams and Tests

When listening to the heart with a stethoscope, the health care provider can hear a sound called a pericardial rub. The heart sounds may be muffled or distant. There may be other signs of fluid in the pericardium (pericardial effusion).

If the disorder is severe, there may be:

  • Crackles in the lungs
  • Decreased breath sounds
  • Other signs of fluid in the space around the lungs

The following imaging tests may be done to check the heart and the tissue layer around it (pericardium):

To look for heart muscle damage, the health care provider may order a troponin I test. Other laboratory tests may include:

Treatment

The cause of pericarditis should be identified, if possible.

High doses of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are often given. These medicines will decrease your pain and reduce the swelling or inflammation in the sac around your heart.

If pericarditis does not go away after 1 to 2 weeks, or it comes back weeks or months later, a medicine called colchicine may be added.

If the cause of pericarditis is an infection:

  • Antibiotics will be used for bacterial infections
  • Antifungal medicines will be used for fungal pericarditis

Other medicines that may be used are:

  • Corticosteroids such as prednisone (in some patients)
  • "Water pills" (diuretics) to remove excess fluid

If the buildup of fluid makes the heart function poorly, treatment may include:

  • Draining the fluid from the sac. This procedure, called pericardiocentesis, may be done using an echocardiography-guided needle.
  • Cutting a small hole (window) in the pericardium (subxiphoid pericardiotomy) to allow the infected fluid to drain into the abdominal cavity

Surgery called pericardiectomy may be needed if the pericarditis is long-lasting, comes back after treatment, or causes scarring or tightening of the tissue around the heart. The operation involves cutting or removing part of the pericardium.

Outlook (Prognosis)

Pericarditis can range from mild illness that gets better on its own, to a life-threatening condition. Fluid buildup around the heart and poor heart function can complicate the disorder.

The outcome is good if pericarditis is treated right away. Most people recover in 2 weeks to 3 months. However, pericarditis may come back. This is called recurrent, or chronic, if symptoms or episodes continue.

Scarring and thickening of the sac-like covering and the heart muscle may occur when the problem is severe. This is called constrictive pericarditis . It can cause long-term problems similar to those of heart failure.

When to Contact a Medical Professional

Call your health care provider if you have symptoms of pericarditis. This disorder is not life threatening most of the time. However, it can be very dangerous if not treated.

Prevention

Many cases cannot be prevented.

References

LeWinter MM, Tischler MD. Pericardial diseases. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 75.

Updated: 5/13/2014

Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com