Pericarditis

Written by Erica Roth | Published on July 25, 2012
Medically Reviewed by George Krucik, MD

What is Pericarditis?

Pericarditis is the inflammation of the sac that surrounds your heart. The sac is a double-layered membrane called the pericardium. The pericardium protects your heart and helps it function properly.

Pericarditis can be caused by a bacterial or viral infection, or an underlying medical condition such as a respiratory infection, heart attack, kidney, or chest injury. Sometimes the cause of pericarditis is unknown.

Pericarditis is most prevalent in men between the ages of 20 and 50, according to the National Institutes of Health (NIH). People who have autoimmune diseases or cancer are more likely to develop pericarditis due to the immuno-suppressant medications they take. (NIH)

Symptoms of Pericarditis

Symptoms of pericarditis vary in each person, but in some cases can mimic the pain of a heart attack. Sharp chest pain associated with pericarditis occurs when the pericardium rubs against the heart muscle. Call 911 or seek immediate medical care if you experience chest pain.

Other physical manifestations of pericarditis include:

  • fluid retention and swelling of the ankles and feet (edema)
  • shortness of breath, especially when lying down
  • extreme fatigue
  • dry cough
  • low-grade fever
  • pain in the neck and shoulder

Some people do not experience pain and the other uncomfortable symptoms of pericarditis, but feel a pressure on their chest due to the inflammation. Fluid accumulation between the layers of membrane can also make you feel like you have a weight on your chest.

Symptoms may develop suddenly and resolve quickly. This situation is referred to as acute pericarditis. A longer-lasting inflammation can linger for up to six months and is called chronic pericarditis.

Pericarditis Treatment

Your doctor will listen to your heart to determine if you have pericarditis. He or she may hear a crackling sound or muffled heartbeat that usually means fluid has built up between the layers of the pericardium. The crackling sound is called pericardial rub.

Imaging tools such as magnetic resonance imaging (MRI), computed tomography (CT) scans, and X-rays can rule out other heart conditions and determine if your heart is enlarged due to the inflammation.

Treatment is prescribed according to the underlying cause and severity of the inflammation. Mild pericarditis may go away on its own without any specific treatment.

Pericarditis caused by a bacterial or fungal infection is treated with antibiotics and antifungal drugs. Your doctor will run blood tests to determine whether a bacterial infection is present in your body.

Viral pericarditis cannot be treated with antibiotics and antifungals. Inflammation of this kind must run its course. You can manage the pain with over-the-counter or prescription pain medications. Discuss your pain level with your doctor. A variety of medications is routinely used to reduce inflammation and ease pain, including:

  • non-steroidal anti-inflammatory drugs (NSAIDs), including acetaminophen, naproxen, and ibuprofen
  • corticosteroids, including prednisone
  • narcotic pain relievers, such as hydrocodone, oxycodone, or codeine

Your doctor may also prescribe a drug called colchicine. This medication shortens the duration of the infection and in some cases can prevent a recurrence of pericarditis.

More invasive procedures may be required if your condition does not respond to medication. Fluid that builds up around the heart can become dangerous, as it makes the heart work harder with each beat. Drainage of the fluid is called pericardiocentesis, and is performed in the hospital.

Surgery to remove hardened areas of the pericardium is called pericardiectomy. The procedure may be used to reduce stress in your heart. A hardened pericardium restricts the movement of your heart, which can create abnormal heart rhythms.

Recovery and Outlook

Mild pericarditis may run its course in a few days, while more severe cases can lead to weeks or months of recovery. Most people heal within two to three weeks of treatment.

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