Acute pericarditis is a condition in which inflammation occurs in the pericardium, the fluid-filled sac that surrounds the heart. “Acute” means the condition develops quickly or suddenly.
The pericardium consists of two thin layers of tissue. Fluid separate these layers, helping prevent them from rubbing together as the heart beats. The function of the pericardium is to hold a person’s heart in place and to avoid friction as the organ beats.
This article explores acute pericarditis in more detail, including its causes, symptoms, and treatment. It also discusses how doctors diagnose acute pericarditis and when a person may need to speak with a healthcare professional.
Acute pericarditis is inflammation of the pericardium that lasts fewer than 4–6 weeks.
The American Heart Association (AHA) notes that acute pericarditis
Other forms of pericarditis
Other forms of pericarditis include:
- Incessant pericarditis: This form lasts more than 4–6 weeks without remission. Remission is when the signs or symptoms disappear.
- Recurrent pericarditis: This describes when a person has a new onset of pericarditis after having no symptoms for 4–6 weeks.
- Chronic pericarditis: This form lasts for more than 3 months.
Potential complications
Acute pericarditis is typically self-limiting, which means it gets better without treatment. It is usually not life threatening.
However, in some instances, acute pericarditis can cause complications, such as:
- pericardial effusion, which is a buildup of fluid inside the pericardium
- cardiac tamponade, which is a significant buildup of fluid in the pericardium that compresses the heart
- constrictive pericarditis, which is when the pericardium becomes thicker and stiffer than usual
- effusive-constrictive pericarditis, which is when constrictive pericarditis and pericardial effusion occur together
There are various symptoms of pericarditis.
Chest pain
The AHA notes that sharp, stabbing chest pain is a
This pain generally comes on quickly, usually on the left or in the middle of the chest. A person may also experience pain in one or both shoulders.
People may find that sitting up and leaning forward helps relieve symptoms. Breathing in deeply or lying down may make symptoms worse.
The AHA advises that people call 911 if they experience chest pain, as this symptom can also indicate a heart attack.
Other associated symptoms
Other symptoms associated with acute pericarditis include:
- a dull ache or pressure in the chest
- coughing
- fever
- weakness
- difficulty breathing
- heart palpitations
Is it a heart attack?
Heart attacks occur when there is a lack of blood supply to the heart. Symptoms include:
- chest pain, pressure, or tightness
- pain that may spread to arms, neck, jaw, or back
- nausea and vomiting
- sweaty or clammy skin
- heartburn or indigestion
- shortness of breath
- coughing or wheezing
- lightheadedness or dizziness
- anxiety that can feel similar to a panic attack
If someone has these symptoms:
- Dial 911 or the number of the nearest emergency department.
- Stay with them until the emergency services arrive.
If a person stops breathing before emergency services arrive, perform manual chest compressions:
- Lock fingers together and place the base of hands in the center of the chest.
- Position shoulders over hands and lock elbows.
- Press hard and fast, at a rate of 100–120 compressions per minute, to a depth of 2 inches.
- Continue these movements until the person starts to breathe or move.
- If needed, swap over with someone else without pausing compressions.
Use an automated external defibrillator (AED) available in many public places:
- An AED provides a shock that may restart the heart.
- Follow the instructions on the defibrillator or listen to the guided instructions.
A review from 2020 notes that viral infections are usually the cause of acute pericarditis in high income countries. However, there is no obvious cause in most cases.
The researchers state that healthcare professionals believe many cases occur due to unknown viral infections or an immune response to infection.
They cite previous studies that indicate that, in under-resourced countries, tuberculosis is the leading cause of acute pericarditis.
Other possible causes include:
- recent digestive or respiratory system infections
- inflammation during heart surgery
- kidney failure
- a heart attack
- cancer
- HIV and AIDS
- injury due to an accident or radiation therapy
- taking certain medications, such as:
The AHA notes that males ages
The 2020 review cites research that indicates acute pericarditis is likely to reoccur in 20–30% of cases. After a reoccurrence of acute pericarditis, a person has about a 50% chance of experiencing additional reoccurrences.
Diagnosing acute pericarditis
Questions a doctor may ask
When taking a medical history, a doctor might ask if the person:
- had a heart attack or experienced an injury to their chest recently
- experienced any recent viral infections
- has any other medical conditions
- is experiencing chest pain, and if so:
- how it feels
- where they feel it
- if it gets worse when lying down or coughing
Physical exam
A healthcare professional may also examine a person physically to check for signs of pericarditis. This may involve using a stethoscope to listen for sounds of the pericardium rubbing against the heart.
Tests
Tests a doctor may use to diagnose acute pericarditis include:
- A chest X-ray: Doctors use these to check for signs of an enlarged heart, which may indicate excess fluid in the pericardium.
- An electrocardiogram: This test measures the heart’s electrical activity.
- A cardiac CT: This scan produces a detailed picture of the heart and pericardium.
- An echocardiogram: This uses sound waves to measure the size and shape of the heart.
- A cardiac MRI: This scan uses magnets to create a detailed picture of the pericardium.
- Diagnostic pericardiocentesis: This test involves a healthcare professional inserting a needle or tube, called a catheter, into the chest wall to remove excess fluid in the pericardium. It is then possible
to analyze the fluid for signs of infection. - Blood tests: A doctor can use these to check the following:
- if there are signs of heart attack
- how inflamed the pericardium is
- if there are possible underlying causes of acute pericarditis
According to a 2020 research review, healthcare professionals generally recommend nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs include aspirin and ibuprofen.
Doctors
Other medications a doctor may use to treat acute pericarditis include:
- corticosteroids
- interleukin-1 blockers, which reduce the body’s inflammatory response
- antibiotics if the condition is the result of a bacterial infection
A doctor
Additionally, a healthcare professional may use therapeutic pericardiocentesis to drain excess fluid from the pericardium, particularly if acute pericarditis has caused cardiac tamponade.
The AHA notes that acute pericarditis
People need to speak with a doctor if they have any signs of acute pericarditis. A common symptom is chest pain, which
People experiencing symptoms of possible complications of acute pericarditis should also seek immediate medical attention. Some of these include:
- coughing
- weakness
- difficulty breathing
- heart palpitations
A healthcare professional may be able to recommend treatment to help a person reduce the likelihood of developing recurring or chronic pericarditis or other health complications.
Cardiovascular health resources
Visit our dedicated hub for more research-backed information and in-depth resources on cardiovascular health.
Acute pericarditis describes inflammation of the pericardium that lasts fewer than 4–6 weeks. While it may go away on its own and
Some possible causes of acute pericarditis include infection, injury, and taking certain medications.
A person should speak with a healthcare professional if they have any signs of acute pericarditis. A doctor can order diagnostic tests and recommend treatment.
People with chest pain should call 911 immediately to rule out the possibility of a heart attack.