Pericarditis is an inflammation of the sac around the heart. In some cases, the inflammation may cause fluid to build up in the sac and make it difficult for the heart to move.


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The exact cause of pericarditis is often unknown. Infections, injuries or chronic disease may be involved in some cases.

Risk Factors

Factors that increase the risk for pericarditis include:

  • Weakened immune system that is not able to fight off infections and other diseases
  • Surgery to repair heart defects or heart disease
  • Infection from virus, bacteria, parasite, or fungus
  • Chest trauma or injury
  • Autoimmune disorders, such as systemic lupus erythematosus


Chest pain is a common symptom. It may start over the left side or center of the chest and spread to the neck and left shoulder. The pain is usually a sharp, stabbing pain that may be worse with deep breathing or lying down.

Other symptoms may include:

  • Shortness of breath
  • Coughing
  • Fever and chills
  • Pain when swallowing
  • Weakness and fatigue
  • Irritability
  • Loss of appetite
  • Irregular heartbeat


You will be asked about your child’s symptoms and medical history. A physical exam will be done. The doctor will listen for a grating or rubbing sound in your child’s heart. If the condition is severe, there may also be a crackle sound in your child’s lungs.

Images may be taken to evaluate the heart and surrounding tissue. This can be done with:

Your child's heart activity may be tested. This can be done with an electrocardiogram (EKG).

Your child's bodily fluids may be tested. This can be done with:

  • Blood tests
  • Pericardiocentesis


The illness can range from mild to life-threatening. Acute inflammatory pericarditis usually improves with treatment within a few weeks or months. Pericarditis caused by chronic inflammatory diseases, like lupus or rheumatoid arthritis, may last longer or occur again.

Treatment options include:


The doctor may advise medication to:

  • Decrease inflammation
  • Manage pain—may be over-the-counter or prescription medication depending on the degree of pain

Antibiotics may be given if the pericarditis is associated with a bacterial infection.


For severe pericarditis, your child may need:

  • Pericardiocentesis—fluid around the heart is removed with a needle
  • Pericadiectomy—the sac around the heart is removed—rarely done


There are no current guidelines to prevent pericarditis.


American Heart Association

National Heart, Lung and Blood Institute


Canadian Cardiovascular Society

Canadian Family Physician


Acute and recurrent pericarditis. EBSCO DynaMed Plus website. Available at: Updated September 26, 2017. Accessed December 27, 2017.

Pediatric pericarditis. Cincinnati Children's website. Available at: Updated July 2016. Accessed December 27, 2017.

Pericarditis. Seattle Children's Hospital website. Available at Accessed December 27, 2017.

Last reviewed November 2018 by EBSCO Medical Review Board Kari Kassir, MD  Last Updated: 12/20/2014