What is Pericarditis?
Pericarditis is a disease characterized by inflammation of the pericardium, a sac-like membrane surrounding your heart. The membrane holds a small amount of fluids, which act as lubrication to prevent friction when the heartbeats. When the layers are inflamed, the result is chest pain.
Pericarditis can be acute if it develops suddenly but does not last for a long time. Pericarditis is considered chronic if the symptoms develop gradually or persist for a long time.
Causes
Often the cause remains unknown. Some common causes of pericarditis include:
- Viral infections
- Heart surgery or heart attack
- Trauma
- Other health disorders such as cancer
- Radiation
- Autoimmune diseases
Symptoms
Symptoms vary depending on the type of pericarditis. Some symptoms can go unnoticed, but those that show up include:
- Sharp, stabbing pain over the center or left side of your chest, which radiates to your neck, arms, shoulder, or jaw
- Shortness of breath when lying down
- Palpitations
- Low-grade fever
- Overall sense of weakness, fatigue, or feeling sick
- Dry cough
- Swelling in your leg, foot, or ankle
Diagnosis
Your doctor diagnoses pericarditis by collecting detailed information about your family's medical history, medications, health problems, and health habits. Your doctor will also carry out a physical examination, during which they will listen for signs of excess fluid and for a related sound known as friction rub.
Your doctor may order other tests such as:
- Electrocardiogram (ECG): a painless test that detects and records your heart's rhythm
- Chest X-ray to detect heart enlargement as well as excess fluid
- Blood tests to check for markers of inflammation
- Echocardiography to view the size, structure, and movement of the heart, and to look for fluid collection around the heart
- MRI or CT scan
- Right-heart catheterization to check for any pressure in your heart
Treatment
Treatment depends on the underlying cause and may include:
- Nonsteroidal anti-inflammatory drugs, or NSAIDs, to decrease pain and inflammation
- Steroids, used for severe attacks when traditional treatment does not work
- Antibiotics, for infection
- Anti-inflammatory drugs such as colchicine, if symptoms last for weeks or recur
Surgery is considered if other treatment does not work. This can include pericardiectomy, which involves the removal of the pericardium. In some cases, removal of excess fluid may be necessary, in a procedure called pericardiocentesis.
Preventing pericarditis may not be possible, but it is possible to minimize the risk of pericarditis recurrence.