Pericarditis & Pericardial Disease

Swelling and irritation of the membrane around your heart, called the pericardium, can cause sharp chest pain as well as other uncomfortable symptoms. This condition is called pericarditis. It can be treated, but an early evaluation is important in order to rule out more serious problems, such as heart attack, and to prevent long-term complications.
Inflammation of the sac around the heart.

Pericarditis, or pericardial disease, refers to inflammation of the membrane around the heart (the pericardium). The most common symptom of pericarditis is chest pain, which is usually described as sharp or stabbing but may instead feel like a dull ache or a sensation of pressure. The pain sometimes spreads to the left shoulder or the neck, and it may get worse when you cough, take a deep breath or lie down. You may feel better when you sit up and lean forward. 

Other potential symptoms of pericarditis include swelling of the legs or abdomen, cough, fatigue, weakness, low-grade fever, a pounding or racing heartbeat (palpitations), and shortness of breath when you lie down.

Pericarditis may develop as a result of a heart attack or heart surgery, which can trigger an inflammatory response. Pericarditis can also be caused by infection, systemic inflammatory disorders (such as lupus and rheumatoid arthritis), or injury to the heart or chest (for example, in a car accident). Other medical conditions that can cause pericarditis include kidney failure, AIDS, tuberculosis, and cancer. In some cases of pericarditis, the precise cause may remain unclear.

You may be at increased risk of developing pericarditis if you are recovering from a heart attack or if you have an autoimmune disease, trauma or injury from an accident, certain kinds of infection, or kidney failure. In rare cases, certain medications may increase the risk of this condition. Men ages 20 to 50 are more likely to develop pericarditis, but it can affect men and women of all ages.

When the sac around the heart is inflamed, the two layers of the pericardium rub against each other, producing a specific sound called a pericardial rub. Your cardiologist will listen for this sound with a stethoscope. Other tools used in diagnosing pericarditis include blood tests, electrocardiogram (ECG), echocardiogram, chest x-ray, CT scan, and MRI.

Treatment of this condition usually focuses on relieving symptoms. Mild pericarditis may get better without treatment. In other cases, medications are often used to reduce inflammation and swelling. Pericarditis caused by bacterial infection will require antibiotics. If pericarditis causes too much fluid to build up around the heart, a minimally invasive procedure can be used to drain the fluid. If chronic (long-term) pericardial disease causes the membrane around the heart to become permanently rigid, the pericardium may need to be surgically removed.