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.

How does it occur?

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

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

Sometimes a cause cannot be found.

What are the symptoms?

Symptoms of pericarditis include:

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

How is it diagnosed?

Your healthcare provider will examine you, listen to your heart with a stethoscope, and ask about your medical history. Your provider may also order the following tests:

• chest X-ray
• ECG (electrocardiogram) to measure and record the electrical activity of your heart
• echocardiogram, which is a cardiac ultrasound scan that uses 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. In some cases your healthcare provider may recommend colchicine or prednisone if the NSAIDS do not work well.

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, which sometimes causes pressure on the heart and affects its ability to pump blood properly (a problem called cardiac tamponade). The fluid may be removed to help take pressure off the heart or to help diagnose the cause of the excess fluid.

If the inflammation lasts a long time, the pericardium may become scarred and stiff. The stiffness may interfere with the way the heart fills with blood. This may cause a drop in blood pressure, trouble breathing, swelling in the neck veins, and edema (swelling in the tissues of the legs). This condition is called constrictive pericarditis. It may require surgery.

How can I prevent pericarditis from recurring?

Most of the causes of pericarditis are not easily prevented.