Pericarditis is an inflammation of the pericardium - the sack-like membrane that contains the heart. In most cases, the illness will pass without medical intervention.
In roughly 90% of patients, the cause of pericarditis is not known, but it can be infectious or noninfectious and is the most common disease of the pericardium.1
In this article, we will discuss pericarditis' causes and symptoms and the interventions used to treat it.
Contents of this article:
- What is pericarditis?
- Symptoms of pericarditis
- Causes of pericarditis
- Tests and diagnosis of pericarditis
- Treatment of pericarditis
Fast facts on pericarditis
Here are some key points about pericarditis. More detail and supporting information is in the main article.
- Pericarditis is a swelling of the pericardium, a sack-like tissue that contains the heart.
- Pericarditis can have a number of causes, including bacterial or viral infection, parasites or fungus.
- Most commonly, pericarditis is due to a virus.
- In general, pericarditis will disappear on its own without treatment.
- Symptoms of pericarditis include palpitations, a dry cough and pain in the shoulder.
- There are a series of imaging tests that are used to diagnose the illness.
- Tuberculosis is the biggest cause of pericarditis worldwide.
- In rare cases, pericarditis can permanently scar the pericardium.
- Colchicine is currently one of the most effective treatments.
What is pericarditis?
Pericarditis is an inflammation of the pericardial sac.
Pericarditis is an inflammation of the pericardium. The swelling causes a sharp pain as the affected pericardial layers rub together and irritate.2
In general, pericarditis starts quickly and does not last particularly long - this is known as acute pericarditis. Often, the illness will pass with little intervention. If pericarditis lasts for a longer period of time, it is referred to as chronic pericarditis.
Chronic pericarditis is further split into two categories:
- Incessant: occurs within 6 weeks of weaning medical treatment for acute pericarditis
- Intermittent: occurs after 6 weeks of weaning medical treatment for acute pericarditis.
Some clinicians further split pericarditis down into five groups, depending on the type of fluid that accumulates around the heart:
- Serous: pale, yellow transparent fluid
- Purulent: white-yellow pus
- Fibrinous: consists of fibrin (a blood clotting agent) and leukocytes (white blood cells)
- Caseous: caseous necrosis is a form of cell death; affected tissue develops a cheese-like appearance
- Hemorrhagic: blood-based fluid.
Symptoms of pericarditis
The symptoms of pericarditis can include the following:
- Sharp pain in the chest, sometimes central, other times to the left; may decrease in intensity when sitting up and leaning forward
- Shortness of breath, especially when reclining
- Minor fever
- General weakness
- Swelling of the abdomen or legs
- Pain in the shoulder.
The symptoms are very similar to a heart attack. It is imperative to seek medical attention if you experience chest pain. A doctor can then rule out less serious conditions and perhaps investigate the reasons for the pericarditis.
Complications of pericarditis
- Cardiac tamponade: if too much fluid builds up in the pericardium it can put additional pressure on the heart, preventing it from fully filling with blood - this can cause a fatal drop in blood pressure if left untreated
- Constrictive pericarditis: a rare byproduct of pericarditis. Constrictive pericarditis involves a permanent thickening and scarring of the pericardium. This causes a hardening of the tissues and restricts the heart from working properly, potentially leading to swelling in the feet and legs and shortness of breath.
On the next page, we look at the causes, diagnosis and available treatment options for pericarditis.
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Article last updated on Tue 22 December 2015.
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All references are available in the References tab.
- Pericarditis: pathophysiology, diagnosis, and management, Imazio M et al., Current Infectious Disease Reports, doi: 10.1007/s11908-011-0189-5, published online August 2013, abstract.
- Mayo Clinic, Pericarditis, accessed 21 December 2015.
- British National Health Service, Pericarditis - causes, accessed 21 December 2015.
- American Family Physician, Diagnosing pericarditis, accessed 21 December 2015.
- Cardiac involvement with parasitic infections, Alicia Hidron et al., Clinical Microbiology Reviews, doi: 10.1128/CMR.00054-09, published online April 2010.
- American Heart Association, What is pericarditis?, accessed 21 December 2015.
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