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Pericarditis Symptoms, Diagnosis, and Treatment

Pericarditis is a viral infection in the pericardium, the sac surrounding your heart.

Most often it doesn't cause serious complications. Sometimes, fluid buildup or thickening of the sac can occur.

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What Is Pericarditis?

Pericarditis is when the pericardium, or the sac surrounding your heart, swells and becomes irritated.

The pericardium is a two-layered sac that keeps your heart in place in your chest and protects the heart from infection. Fluid between the layers keeps friction from building up when the heart beats.

This sac swells when it gets inflamed, often by a virus or bacteria, causing pericarditis.

Types of pericarditis

Pericarditis can be:

  • Acute. It comes on suddenly and resolves on its own, often within three months.
  • Chronic. It comes on slowly and can take longer to go away.
  • Recurrent. It comes back after at least four weeks. Between the inflammation episodes, you have no symptoms. These episodes can come and go over months or years.

Causes of pericarditis

A viral infection is the most common cause of pericarditis. It may happen after a viral illness like the flu or bronchitis.

Some conditions can cause your body to react to a medical condition or treatment. Any event or condition that causes inflammation of the sac holding the heart can lead to pericarditis.

Other causes include:

  • Heart attack.
  • Chest injury.
  • Heart surgery.
  • Some autoimmune disorders.

Pericarditis risk factors

Men ages 16 to 65 are the most likely to get pericarditis. Often, the cause is unknown.

Recent viral illness is the most common risk factor.

Other risk factors include:

  • Autoimmune disorders, such as lupus, rheumatoid arthritis, or scleroderma.
  • Prior heart attack.
  • Recent heart surgery, heart catheterization, or radiation.
  • Kidney failure.
  • Injury from an accident.
  • Certain drugs, such as blood thinners, or to treat an irregular heartbeat.

Pericarditis complications

This infection often doesn't cause serious complications, and symptoms resolve within a week or two.

Some pericarditis complications include:

  • Fluid buildup around the heart.
  • Sudden pressure on the heart makes it hard to pump enough blood.
  • Thickening of the sac around the heart.

Preventing pericarditis

There's no way to prevent acute pericarditis.

But you can take steps to help prevent infections and reduce the risk of pericarditis.

You should:

  • Avoid exposure to viruses, such as the flu.
  • Wash your hands often to prevent the spread of illnesses.
  • Stay up to date on vaccines.

Your doctor may prescribe medicine (Colchicine) to prevent recurrent pericarditis.

Pericarditis Symptoms and Diagnosis

Pericarditis symptoms

The main symptom of pericarditis is sharp, stabbing chest pain. It may be in the center or left side of the chest and can spread to the shoulder.

The pain can last for hours or days and doesn't get better when you rest. Lying down and deep breathing can make it worse.

Pericarditis can also cause the same symptoms as other viral infections, such as:

  • Fever.
  • Weakness.
  • Fatigue.

Other symptoms of pericarditis include:

  • Trouble breathing when you lie down.
  • Dry cough.
  • Heart palpitations.
  • Tiredness or weakness.
  • Swelling of the legs or belly.

Although the pain can be scary, pericarditis isn't dangerous for most people, and the symptoms resolve without treatment.

When to see a doctor about pericarditis

You should see a doctor if you have chest pain.

Pericarditis symptoms are like those of other heart and lung conditions. A doctor should assess your symptoms.

If you're worried the chest pain is a heart attack, call 911 or go to the nearest ER right away.

Diagnosing pericarditis

Your doctor will do a physical exam, listen to your heart, and ask questions about your recent health history.

They may also order tests to confirm a pericarditis diagnosis, such as:

  • Echocardiogram. This is an ultrasound that uses sound waves to create images of the heart. It looks for fluid around the heart and sees how well it works.
  • EKG. This test records the heart's electrical activity. It can look for changes in your heart's rhythm.
  • Chest x-ray. This test looks at the size of your heart and checks for fluid in the lungs.
  • Blood tests. Blood tests look for the underlying cause of pericarditis, such as infection or a health condition.

Pericarditis Treatment

If caused by a viral infection and you have no other problems, pericarditis treatment includes rest and — if needed — anti-inflammatory drugs (NSAIDs). Antibiotics don't work on viral infections.

Your doctor may suggest NSAIDs — like ibuprofen or aspirin — to lessen the chest pain and reduce swelling. For severe pain, your doctor may prescribe a drug called colchicine.

For most people, pericarditis resolves on its own with rest.

See your heart doctor for a follow-up if your symptoms don't improve within a few weeks. They may prescribe other treatments if you have any problems.