Pericarditis: Symptoms, diagnosis, and treatment

Pericarditis is an inflammation of the pericardium, the sack-like membrane that contains the heart. In most cases, the illness will pass without treatment.

In many cases, the cause of pericarditis is not known, but it can be infectious or noninfectious and is the most common disease of the pericardium.

This MNT Knowledge Center article will discuss pericarditis’ causes and symptoms and the interventions used to treat it.

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.

The condition can have a number of causes, including bacterial or viral infection, parasites, or fungus.

Most commonly, pericarditis is due to a virus.

Symptoms of pericarditis include palpitations, a dry cough, and pain in the shoulder.

In rare cases, pericarditis can permanently scar the pericardium.

What is pericarditis?

[Heart anatomy in chest]
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.

In general, pericarditis starts quickly and does not last long – this is known as acute pericarditis. If pericarditis lasts for a longer period, it is referred to as chronic pericarditis.

Chronic pericarditis is further split into two categories:

Incessant: This type occurs within 6 weeks of weaning medical treatment for acute pericarditis.

Intermittent: The type occurs after 6 weeks of reducing 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: This involves pale, yellow, transparent fluid.

Purulent: This group is identified by the presence of white-yellow pus.

Fibrinous: This group consists of fibrin, a blood clotting agent, and leukocytes, a type of white blood cells.

Caseous: Caseous necrosis is a form of cell death. Affected tissue develops a cheese-like appearance

Hemorrhagic: This type involves a blood-based fluid.

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Symptoms

The symptoms of pericarditis can include the following:

sharp pain in the chest, sometimes central, other times to the left, that may decrease in intensity when sitting up and leaning forward

palpitations

shortness of breath, especially when reclining

minor fever

general weakness

swelling of the abdomen or legs

a cough

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 investigate the cause of the pericarditis.

Complications

If pericarditis is left untreated, it can get worse and become a more severe condition.

Complications of pericarditis include:

Cardiac tamponade: If too much fluid builds up in the pericardium, it can put additional pressure on the heart, preventing it from filling with blood. This can cause a fatal drop in blood pressure if left untreated

Constrictive pericarditis: This is 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.

Causes

The pericardial sac, or pericardium, consists of two layers, separated by a small amount of fluid. This fluid keeps the movement between the two membranes smooth.

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