Pericarditis is swelling and irritation of the pericardium, the thin saclike membrane surrounding your heart. Pericarditis often causes chest pain and sometimes other symptoms. The sharp chest pain associated with pericarditis occurs when the irritated layers of the pericardium rub against each other.
Pericarditis usually begins suddenly but doesn't last long (acute). When symptoms develop more gradually or persist, pericarditis is considered chronic.
Most cases are mild and usually improve on their own. Treatment for more-severe cases may include medications and, rarely, surgery. Early diagnosis and treatment may help to reduce the risk of long-term complications from pericarditis.
Pericarditis care at Mayo Clinic
Source: http://www.mayoclinic.com
Pericarditis has different classification types, depending on the pattern of symptoms and how long symptoms last. Acute pericarditis usually lasts less than three weeks. Incessant pericarditis lasts about four to six weeks but less than three months and is continuous.
Pericarditis is described as recurrent if it occurs about four to six weeks after an episode of acute pericarditis with a symptom-free interval in between. Pericarditis is considered chronic if symptoms last longer than three months.
If you have acute pericarditis, the most common symptom is sharp, stabbing chest pain behind the breastbone or in the left side of your chest. However, some people with acute pericarditis describe their chest pain as dull, achy or pressure-like instead, and of varying intensity.
The pain of acute pericarditis may travel into your left shoulder and neck. It often intensifies when you cough, lie down or inhale deeply. Sitting up and leaning forward can often ease the pain. At times, it may be difficult to distinguish pericardial pain from the pain that occurs with a heart attack.
Chronic pericarditis is usually associated with chronic inflammation and may result in fluid around the heart (pericardial effusion). The most common symptom of chronic pericarditis is chest pain.
Depending on the type, signs and symptoms of pericarditis may include some or all of the following:
Seek immediate medical care if you develop new symptoms of chest pain.
Many of the symptoms of pericarditis are similar to those of other heart and lung conditions. The sooner you are evaluated, the sooner you can receive proper diagnosis and treatment. For example, although the cause of acute chest pain may be pericarditis, the original cause could have been a heart attack or a blood clot of the lungs (pulmonary embolus).
Source: http://www.mayoclinic.com
Under normal circumstances, the two-layered pericardial sac that surrounds your heart contains a small amount of lubricating fluid. In pericarditis, the sac becomes inflamed and the resulting friction from the inflamed sac leads to chest pain.
The cause of pericarditis is often hard to determine. In most cases, doctors either are unable to determine a cause (idiopathic) or suspect a viral infection.
Pericarditis can also develop shortly after a major heart attack, due to the irritation of the underlying damaged heart muscle. In addition, a delayed form of pericarditis may occur weeks after a heart attack or heart surgery.
This delayed pericarditis is known as Dressler's syndrome. Dressler's syndrome may also be called postpericardiotomy syndrome, post-myocardial infarction syndrome and post-cardiac injury syndrome.
Other causes of pericarditis include:
Source: http://www.mayoclinic.com
Your doctor likely will start by taking your medical history and asking questions about your chest pain and other symptoms. As part of your initial evaluation, your doctor will also perform a physical exam and check your heart sounds.
While listening to your heart, your doctor will place a stethoscope on your chest to check for the sounds characteristic of pericarditis, which are made when the pericardial layers rub against each other. This characteristic noise is called a pericardial rub.
Your doctor may have you undergo tests that can help determine whether you've had a heart attack, whether fluid has collected in the pericardial sac or whether there are signs of inflammation. Your doctor may use blood tests to determine if a bacterial or other type of infection is present.
You may also undergo one or more of the following diagnostic procedures:
Electrocardiogram (ECG). In this test, patches with wires (electrodes) are attached to your skin to measure the electrical impulses given off by your heart.
Impulses are recorded as waves displayed on a monitor or printed on paper. Certain ECG results may indicate pericarditis, while others could indicate a heart attack.
Computerized tomography (CT). This X-ray technique can produce more-detailed images of your heart and the pericardium than can conventional X-ray studies.
CT scanning may be done to exclude other causes of acute chest pain, such as a blood clot in a lung artery (pulmonary embolus) or a tear in your aorta (aortic dissection). CT scanning can also be used to look for thickening of the pericardium that might indicate constrictive pericarditis.
Source: http://www.mayoclinic.com
Complications of pericarditis may include:
Constrictive pericarditis. Although uncommon, some people with pericarditis, particularly those with long-term inflammation and chronic recurrences, can develop permanent thickening, scarring and contraction of the pericardium.
In these people, the pericardium loses much of its elasticity and resembles a rigid case that's tight around the heart, which keeps the heart from working properly. This condition is called constrictive pericarditis and often leads to severe swelling of the legs and abdomen, as well as shortness of breath.
Cardiac tamponade. When too much fluid collects in the pericardium, a dangerous condition called cardiac tamponade can develop.
Excess fluid puts pressure on the heart and doesn't allow it to fill properly. That means less blood leaves the heart, which causes a dramatic drop in blood pressure. Cardiac tamponade can be fatal if it isn't promptly treated.
Early diagnosis and treatment of pericarditis usually reduces the risk of the long-term complications.
Source: http://www.mayoclinic.com
For most mild cases of pericarditis, rest and over-the-counter pain medications â taken under your doctor's direction â may be all that's needed. While you recuperate, avoid rigorous physical activity. Strenuous activity can trigger pericarditis symptoms. Ask your doctor how long you need to take it easy.
Source: http://www.mayoclinic.com
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