Pericarditis

What is pericarditis?

Pericarditis is inflammation of the pericardium, the thin sac (membrane) that surrounds the heart.

The pericardium holds the heart in place and helps it work properly. There is a small amount of fluid between the inner and outer layers of the pericardium. This fluid keeps the layers from rubbing as the heart moves to pump blood.

What causes pericarditis?

Usually, the cause of pericarditis is unknown, but may include: 

  • Infection by viruses, bacteria, a
    fungus, or parasites
  • Autoimmune disorder(such as lupus,
    rheumatoid arthritis, or scleroderma
  • Inflammation after a heart attack
  • Chest  injury
  • Cancer
  • HIV/AIDS
  • Tuberculosis
  • Kidney failure
  • Medical treatments such as certain
    medicines or radiation therapy to the chest
  • Heart surgery

What are the symptoms of pericarditis?

The following are the most common signs of pericarditis:

  • Chest pain that:
    • Can especially be felt behind
      the breastbone, and sometimes beneath the collarbone (clavicle), neck, and left
      shoulder
    • Is a sharp, piercing pain over
      the center or left side of the chest that gets worse when you take a deep
      breath. It usually gets better if you sit up or lean forward.
    • Feels a lot like a heart attack
  • Fever
  • Weakness and tiredness
  • Coughing
  • Trouble breathing
  • Pain when swallowing
  • Pounding feeling when your heart
    beats (palpitations)

The symptoms of pericarditis may look like other conditions. See a healthcare provider for a diagnosis.

How is pericarditis diagnosed?

If your healthcare provider
suspects pericarditis, he or she will listen to your heart very carefully. A common sign
of pericarditis is a pericardial rub. This is the sound of the pericardium rubbing
against the outer layer of your heart. Other chest sounds that are signs of fluid in the
pericardium (pericardial effusion) or the lungs (pleural effusion) may also be
heard.

Your healthcare provider may also check for pulsus paradoxus. This is when your blood
pressure drops when you take a deep breath. The changes in the pressure in your chest
keep blood from returning from your body and entering your heart.

Along with a health history and
physical exam, you may also need certain tests. These may include:

  • Echocardiogram
    (echo). This test uses sound waves to
    check your heart’s size and shape. The echo sound waves create a picture on a screen
    as an ultrasound transducer is passed over the skin over the heart. Echo can show how
    well your heart is working and whether fluid has built up around your heart.
  • Electrocardiogram
    (ECG). This test records the strength
    and timing of the electrical activity of the heart. It shows abnormal rhythms and can
    sometimes detect heart muscle damage. Small sensors are taped to your skin to pick up
    the electrical activity.
  • Chest X-ray. An X-ray may be done to
    check your lungs and see if your heart is enlarged.
  • Cardiac MRI. This is an imaging test
    that takes detailed pictures of the heart. It may be used to look for thickening or
    other changes in the pericardium.
  • Cardiac CT. This type of X-ray takes
    a clear, detailed picture of your heart and pericardium. It may be used to help rule
    out other causes of chest pain.
  • Blood tests. Certain blood tests can
    help rule out other heart problems, such as heart attack, and can tell the doctor how
    much inflammation there is in your body.