Pericarditis is irritation and swelling of the pericardium, which is the thin sac that surrounds the heart. Extra fluid that builds up between the 2 layers of the pericardium restricts the heart’s action.
The cause of pericarditis is often unknown. However, possible causes include:
- Viral, bacterial, or fungal infection
- 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 treatment
- Certain medications used to suppress the immune system
A weakened immune system may increase your chance of pericarditis.
Chest pain is a common symptom of pericarditis, especially over the left side or center of the chest. It sometimes spreads to the neck and left shoulder. It is usually a sharp, stabbing pain. Deep breathing or lying down may worsen the pain. Sitting up may lessen it. Other symptoms may include:
- Shortness of breath
- Fever and chills
- Pain when swallowing
- Weakness and fatigue
The doctor will ask about your symptoms and medical history. A physical exam will be done. A stethoscope will be used to listen for a grating or rubbing sound in your heart. If the condition is severe, there may be a crackle sound in your lungs. The following tests may be performed:
Images of your heart may need to be taken. This can be done with:
Your bodily fluid may need to be tested. This can be done with:
- Blood tests
Treating pericarditis depends on the cause, if the cause is known. In many cases, when the cause is unknown or viral pericarditis is suspected, pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) are given. In other cases, corticosteroids may be given. Antibiotics are used to treat bacterial infections that cause pericarditis.
If the fluid is seriously affecting the heart’s ability to pump, the fluid may need to be removed through pericardiocentesis, which is the same procedure used for testing. In rare cases, surgery may be performed.
Depending on the cause of the pericarditis, the illness can range from mild to life-threatening. Acute inflammatory pericarditis usually subsides with treatment within a few weeks or months. However, pericarditis caused by chronic inflammatory diseases, like systemic lupus erythematosus or rheumatoid arthritis, may last longer or tend to recur.
Pericarditis may be prevented in the future with certain anti-inflammatory medications. Talk to your doctor about whether this is right for you.
American Heart Association
National Heart, Lung and Blood Institute
Canadian Cardiovascular Society
The College of Family Physicians of Canada
Acute pericarditis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 3, 2012. Accessed March 25, 2013.
Pericarditis. Texas Heart Institute website. Available at http://www.texasheart.org/HIC/Topics/Cond/pericard.cfm. Updated October 2012. Accessed March 25, 2013.
What is pericarditis? American Heart Association website. Available at http://www.heart.org/HEARTORG/Conditions/More/What-is-Pericarditis_UCM_444931_Article.jsp. Updated February 27, 2013. Accessed March 25, 2013.
11/4/2013 DynaMed's Systematic Literature Surveillance. Available at: http://www.ebscohost.com/dynamed: Imazio M, Brucato A, et al. A randomized trial of colchicine for acute pericarditis. N Engl J Med. 2013;369(16):1522-1528.
Last reviewed December 2014 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.