Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.
The cause of pericarditis is often unknown or unproven, but is often the result of an infection such as:
In addition, pericarditis may be seen with diseases such as:
Other causes include:
Often the cause of pericarditis is unknown. Pericarditis most often affects men ages 20 - 50.
Chest pain is almost always present. The pain:
You may have fever, chills, or sweating if the condition is caused by an infection.
Other symptoms include:
When listening to the heart with a stethoscope, the health care provider can hear a sound called a pericardial rub. The heart sounds may be muffled or distant. There may be other signs of fluid in the pericardium (pericardial effusion).
If the disorder is severe, there may be:
The following imaging tests may be done to check the heart and the tissue layer around it (pericardium):
To look for heart muscle damage, the health care provider may order a troponin I test. Other laboratory tests may include:
The cause of pericarditis must be identified, if possible.
High doses of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are often given. These medicines will decrease your pain and reduce the swelling or inflammation in the sac around your heart.
A medicine called colchicine may be added, especially if pericarditis does not go away after 1 to 2 weeks or it comes back weeks or months later.
If the cause of pericarditis is an infection:
Other medicines that may be used are:
If the buildup of fluid makes the heart function poorly, treatment may include:
If the pericarditis is chronic, recurrent, or causes scarring or tightening of the tissue around the heart, cutting or removing part of the pericardium may be needed. This surgery is called a pericardiectomy.
Pericarditis can range from mild cases that get better on their own to life-threatening cases. The condition can be complicated by fluid buildup around the heart and poor heart function.
The outcome is good if the disorder is treated right away. Most people recover in 2 weeks to 3 months. However, pericarditis may come back. This is called recurrent, or chronic if symptoms or episodes continue.
Scarring and thickening of the sac-like covering and the heart muscle may occur in severe cases. This is called constrictive pericarditis, and it can cause long-term problems similar to those of heart failure.
Call your health care provider if you have symptoms of pericarditis. This disorder is usually not life threatening, but it can be if not treated.
Many cases are not preventable.
LeWinter MM, Tischler MD. Pericardial diseases. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 75.
Updated by: Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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