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Pericarditis

This factsheet is for people who have pericarditis, or who would like information about it.

Pericarditis is inflammation of the pericardium – the sac that surrounds and protects the heart.

Click on the tabs below for more information about pericarditis.

Publication date: April 2010

About

About

About pericarditis


Your pericardium is a double-layered sac that surrounds your heart. Pericarditis is inflammation of your pericardium. It’s a common disorder that has many different causes.

Pericarditis can be recurrent; this means that your symptoms may go away and come back again over several years.

Causes of pericarditis


Pericarditis happens when there is blood, fluid or damaged tissue in between the two layers of your pericardium. Causes of pericarditis include:

  • an infection, such as tuberculosis, but more commonly a viral infection
  • an inflammatory condition such as rheumatoid arthritis or systemic lupus erythematosus (SLE)
  • a heart attack (this is known as Dressler’s syndrome)
  • heart surgery
  • certain types of cancer
  • waste products building up in your blood due to kidney disease or kidney failure (this is called uraemia)
  • an injury to your chest
  • radiotherapy to your chest area
  • an underactive thyroid (hypothyroidism)
However, for many people with pericarditis, there is no clear cause.

Symptoms and diagnosis

Symptoms and diagnosis

Symptoms of pericarditis


The main symptom of pericarditis is a sharp pain in your chest. The pain may go away if you sit forwards. The pain may spread to your left shoulder and/or arm, your abdomen (tummy), neck or back.

The pain may get worse when you lie down flat or on your left side, breathe in, swallow, cough or when you change position. You may find it helps if you keep your back straight when you’re sitting or standing.

Other symptoms of pericarditis include:

  • fever (high temperature)
  • difficulty breathing
  • a dry cough
  • tiredness
  • feeling generally unwell
If you have these symptoms, see a doctor for advice.

Diagnosis of pericarditis


A doctor will ask about your symptoms and examine you. He or she will listen to your heart with a stethoscope. If the doctor can hear a ‘rubbing’ sound (called pericardial rub), this may be a sign of pericarditis.

The doctor may refer you to a cardiologist (a doctor who specialises in conditions of the heart and blood vessels) for further tests.

You may need to have an echocardiogram (an ultrasound scan of your heart) so that the doctor can see if there is any fluid in between the two layers of your pericardium.

Other tests you may have include:

  • blood tests
  • an electrocardiogram (ECG) - a test that measures the electrical activity of your heart to see how well it’s working
  • a chest X-ray
  • a CT scan
  • an MRI scan
  • an angiogram - a test that uses an injection of a special dye into your blood vessels to makes them clearly visible on X-ray images
Please note that availability and use of specific tests may vary from country to country.

Complications

Complications

Pericarditis can sometimes lead to conditions called pericardial effusion and constrictive pericarditis.

Pericardial effusion is when fluid collects between the two layers of your pericardial sac. If lots of fluid builds up, it can put pressure on your heart and prevent it from filling with blood properly. This is called cardiac tamponade.

If this happens, you may need to have a procedure to remove excess fluid from your pericardium. This is called pericardiocentesis or a pericardial tap. A doctor will insert a thin tube through your chest to drain the fluid away. If the fluid keeps coming back you may need to have an operation to help drain it.

Constrictive pericarditis is when your pericardium becomes thicker and stiff. The reason for this is usually a long-term infection, most commonly tuberculosis. However, sometimes there is no clear cause. The condition stops your heart filling with blood properly in between your heartbeats. If you have constrictive pericarditis, you may need to have an operation to remove all or part of your pericardium in order to improve the function of your heart.

Treatment

Treatment

The underlying cause of pericarditis will be treated if possible. For example, if it’s caused by an infection such as tuberculosis, your doctor will prescribe you a course of antibiotics to take.

Your doctor may prescribe you non-steroidal anti-inflammatory medicines (NSAIDs) for the pain. These will relieve chest pain for most people.

If you have recurrent pericarditis, your doctor may prescribe you a medicine called colchicine or type of medicine called a steroid.

Always read the information leaflet that comes with your medicine, and if you have any questions ask your pharmacist or doctor for advice.

Availability and use of different treatments may vary from country to country. Ask your doctor for advice on your treatment options.

Sources

Sources

  • Pericarditis and myocarditis. British Heart Foundation, May 2008. www.bhf.org.uk
  • Troughton RW, Asher CR, and Klein AL, Pericarditis. The Lancet, 2004. 363(9410): 717-27. doi:10.1016/S0140-6736(04)15648-1
  • Simon C, Everitt H, and Kendrick T. Oxford handbook of general practice. 2nd ed. Oxford: Oxford University Press, 2005:350
  • Pericarditis, acute. eMedicine. www.emedicine.medscape.com, accessed 7 January 2010

This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. This content was compiled by Bupa based on clinical information and practice current as at the stated date of publication. Content is likely to reflect clinical practice in a particular geographical region (as indicated by the sources cited) – accordingly, it may not reflect clinical practice in the reader’s country of habitation. This content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Photos and videos are only for illustrative purposes and do not reflect every presentation of a condition.

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