Definition

Pericarditis is swelling and inflammation of the sac around the heart. This can make it hard for the heart to work as it should. It can range from mild to severe and life-threatening.

Pericarditis Copyright © Nucleus Medical Media, Inc.

Causes

The cause of pericarditis is often unknown. Some causes may be:

• Infections from viruses, bacteria, fungi, or parasites
• Heart attack
• Inflammatory diseases such as rheumatoid arthritis or systemic lupus erythematosus
• Cancer that has spread from a tumor near the heart
• Kidney failure
• Injury or surgery affecting the chest, esophagus, or heart
• Radiation therapy
• Certain medicines used to suppress the immune system

Risk Factors

The risk of pericarditis may be higher in people with immune system problems.

Symptoms

Symptoms of pericarditis may include:

• Sharp, stabbing chest pain—worsens with breathing in or lying down
• Problems breathing
• Fever and chills
• Fast heartbeats
• Pain when swallowing
• Weakness and tiredness

Diagnosis

The doctor will ask about symptoms and health history. A physical exam will be done. The doctor will listen for abnormal sounds in the heart or lung.

Images of the heart and chest will confirm the diagnosis. They may be taken with:

• Chest x-ray
• ECG —shows the electrical activity of the heart
• Echocardiogram —shows how well the heart muscle is working
• MRI scan or CT scan —detailed images of tissue in the chest

Other tests may be needed to find the cause. Tests may include:

• Blood tests
• Pericardiocentesis—test of fluid around the heart

Treatment

The main goal is to ease pain and swelling. If a cause is known, it will be treated as well.

Mild swelling will often pass in a few weeks or month. Care may include:

• Rest
• NSAID medicine to reduce swelling
• Follow up with your doctor to check on progress

Severe swelling can be an emergency. It may make it hard for the heart to beat. Hospital care may be needed. Treatment may include:

• Removing fluid from the heart sac. The fluid is removed with a needle.
• Surgery to open the sac. This will ease pressure on the heart. This is a rare option.

Other inflammatory diseases raise the risk of pericarditis. It may last longer or tend to recur. A treatment plan will be made to help decrease the risk of more problems.

Prevention

There are no current guidelines to prevent pericarditis.