Pericarditis

What is pericarditis?

Pericarditis is a condition in which the pericardium becomes inflamed. The pericardium is the thin membrane that covers the heart. It is made up of tissue that is loose enough to allow the heart to move and change in size. Inflammation of the pericardium can cause chest pain.

How does it occur?

Inflammation of the membrane around the heart can be caused by:

• infection, usually caused by a virus
• injury to the heart
• rheumatic fever
• myocardial infarction (heart attack)
• connective tissue disease, such as lupus
• cancer.

Sometimes a cause cannot be identified.

What are the symptoms?

Symptoms of pericarditis include:

• sharp chest pain that gets worse when you take a deep breath, change the position of your body, or start coughing
• pain when you swallow (if the back part of the heart covering is inflamed)
• fever
• pain that decreases when you sit up or lean forward
• tiredness
• shortness of breath.

How is it diagnosed?

To diagnose pericarditis, the doctor will examine you and take your medical history. The most important sign of pericarditis is an unusual sound that your doctor hears with a stethoscope. Your doctor may also order the following tests:

• chest x-ray
• ECG
• cardiac ultrasound scan (use of high-frequency sound to get a picture of the heart)
• blood tests
• tuberculin skin tests.

How is it treated?

The treatment is usually nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines calm down the inflammation of the pericardium.

If you have a fever:

• Stay in bed if your temperature is over 100°F (37.8°C). After your temperature has fallen below 100°F (37.8°C), become as active as you comfortably can.
• Keep a record of your daily temperature.

How long will the effects last?

It may take a few days to several weeks to get better.

The space between the inner and outer layers of the pericardium may fill with excess fluid, causing pressure on the heart and limiting its ability to pump blood properly. This condition, called cardiac tamponade, may require removal of the fluid.

When the inflammation lasts a long time, the pericardium may become scarred and rigid. The rigidity may interfere with the way the heart fills with blood. This may result in a drop in blood pressure, difficulty breathing, swelling in the neck veins, and edema (swelling in the tissues of the legs). Correcting this condition, called constrictive pericarditis, may require surgery.

How can I prevent pericarditis from recurring?

Most of the causes are not easily prevented. You can be aware of the symptoms and contact your doctor immediately if they reappear.