Pericarditis

Written by Lydia Krause | Published on July 16, 2012
Medically Reviewed by George Krucik, MD on July 16, 2012

What is Pericarditis?

Pericarditis is a condition in which the sac surrounding your heart, called the pericardium, becomes swollen and inflamed. You can develop this condition after having a heart attack. Your risk is higher if you’ve had other heart attacks, a serious chest injury, or open-heart surgery. Pericarditis can be treated, but there’s a chance that it could return. It can be life threatening when left untreated.

What Causes Pericarditis?

After a heart attack, your immune system tries to fix the resulting damage to your heart tissue. In cases of pericarditis, instead of repairing this damage, your body’s immune response causes inflammation in the layers of tissue that surround your heart. The exact reason why this happens isn’t known. This condition occurs in about 10 percent of people who have heart attacks, according to American Medical Association Guide to Preventing and Treating Heart Disease (Lipsky, et al., 2008).

The Two Types of Pericarditis

One type of pericarditis occurs within two to five days following a heart attack. The other type, known as Dressler’s syndrome, occurs weeks or months after you’ve had a heart attack. Both types are believed to occur as a result of your body’s attempt to repair itself.

Recognizing the Symptoms of Pericarditis

How soon after a heart attack that your symptoms start will depend on which type of pericarditis you have.

One of the most common symptoms of pericarditis is chest pain. It might feel like a sharp pain or you may feel tightness in your chest. The pain might be worse when you’re inhaling or lying down. It might also disappear when you move to an upright position. You might feel the pain spread to your neck, back, shoulders, or abdomen. You should call your doctor if you have pain that lasts longer than a few minutes.

Other symptoms include:

  • shortness of breath
  • fever, which occurs more often with Dressler’s syndrome
  • fatigue
  • rapid heart rate
  • a general feeling of illness (known as malaise)
  • anxiety
  • dry cough

How Dangerous Is Pericarditis?

Untreated pericarditis can lead to serious complications.

Cardiac Tamponade

This condition occurs when fluids build up inside your pericardium, increasing the pressure on your heart and making it harder for the heart to pump blood. Cardiac tamponade is rare but can be life threatening. It requires immediate medical treatment.

Constrictive Pericarditis

This condition occurs when your pericardium becomes too thick or is covered by scars due to chronic inflammation or multiple cases of pericarditis. It makes it more difficult for your heart to pump blood. This condition is rare and can be life threatening when left untreated.

Congestive Heart Failure

This chronic condition occurs when your heart is unable to pump the right amount of blood to the rest of your body. This causes fluids to build up in other parts of your body, including your liver, lungs, arms, legs, and gastrointestinal tract. This condition can be controlled with medicine and lifestyle changes in most cases.

How Is Pericarditis Diagnosed?

Your doctor will listen to your heart with a stethoscope. A scratchy or rubbing sound could indicate inflammation. A heartbeat that sounds distant is often associated with a fluid buildup. This occurs more often with Dressler’s syndrome.

Other tests might include:

  • chest X-rays to detect a fluid buildup and rule out other potential causes like pneumonia
  • an electrocardiogram to check for electrical impulse changes that could indicate increased pressure on your heart
  • an echocardiogram to look for fluid building up around your heart. This test makes images of your heart using sound waves.
  • blood tests to check for inflammation

How Is Pericarditis Treated?

Treatment of pericarditis is done to decrease inflammation and manage pain and other symptoms.

Medications

Over-the-counter pain relievers, such as aspirin, ibuprofen, and naproxen are often used to treat pericarditis.

Prescription drugs, such as colchicine and corticosteroids, are used when over-the-counter drugs aren’t effective. Colchicine reduces inflammation and is sometimes used for persistent or recurring pericarditis. However, it can cause kidney or liver damage in people with certain health issues. Corticosteroids also reduce inflammation, but they’re only prescribed if other drugs don’t work. They can cause severe side effects and make it harder for heart tissue to heal.

Fluid Drainage

You might need to have excess fluid drained if you have a more severe case of Dressler’s syndrome. This procedure, known as pericardiocentesis, is done by inserting a needle or thin tube into your chest to drain the fluid.

Surgery

You might need to have your pericardium surgically removed if it’s scarred or thick enough to prevent your heart from functioning normally. This procedure is called a pericardiectomy.

How Can I Lower My Heart Attack Risk?

You can reduce your chances of having a heart attack by adopting a heart-healthy lifestyle and treating conditions that are associated with a higher heart attack risk. This helps lower your risk of developing coronary heart disease, which is a leading cause of heart attacks.

Diet

A diet that’s good for your heart includes plenty of fruits and vegetables. You should also eat whole grains, lean meats, and low-fat dairy products. Avoid eating foods that are high in saturated fat, sodium, cholesterol, added sugars, and trans fat.

Exercise

Being physically active helps keep your heart healthy and helps you lose excess weight. If you don’t exercise on a regular basis or if you have certain health conditions, such as heart disease, ask your doctor to recommend a safe exercise routine.

Weight Loss

If you’re obese or overweight, losing excess body fat can lower your risk of having a heart attack. Ask your doctor for advice on controlling your weight through diet and exercise.

Smoking

Take steps to quit smoking as soon as possible. Smoking is associated with a higher risk of having a heart attack. You should also limit your exposure to secondhand smoke.

Health Conditions

Conditions such as diabetes, high blood pressure, and high cholesterol can raise your heart attack risk. Follow your doctor’s recommendations for treating these conditions.

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