Pericarditis

Treating Cardiovascular Diseases in Wisconsin and Northern Illinois

Pericarditis is a condition that occurs when the pericardium, the sac that surrounds your heart, becomes red, swollen and inflamed. When the pericardium swells, it rubs against the heart, causing chest pains and other symptoms of pericarditis.

Pericarditis tends to come on suddenly and last for several months. It can affect people of all ages, but men aged 20 to 50 are more likely to develop it than others.

The pericardium protects your heart from infection and malignancy. It also holds your heart in place and prevents it from over-expanding when blood volume increases.

This protective sac is made up of two thin layers of tissue that are separated by a small amount of fluid, which prevents them from rubbing against each other and creating friction. Sometimes excess fluid develops between these layers, a condition known as pericardial effusion. Learn more about pericardial effusion symptoms.

Symptoms of Pericarditis 

The primary symptoms of pericarditis involve sharp, stabbing chest pains that come on quickly, striking in the middle or left side of the chest. Sometimes the pain extends into the shoulders, neck or back. Chest pain may ease when sitting up and leaning forward but worsen when lying down.Other signs and symptoms of pericarditis may include fever, weakness, heart palpitations, trouble breathing and a dry cough.

When the condition is chronic, or lasting several months, symptoms of pericarditis may include tiredness, shortness of breath and coughing, although chest pain is often absent. If chronic pericarditis becomes severe, signs of pericarditis may also include low blood pressure and swelling in the stomach and legs.

In some people, the chest pain may feel like a heart attack. In these cases, it’s best to call 911 or your local emergency number right away because you could be having a heart attack. Learn more about heart attack signs and symptoms.

Risks and Causes of Pericarditis

In many cases, the cause of pericarditis remains unknown. However, the following are known to trigger this condition: 

  • Autoimmune disease, such as lupus, scleroderma and rheumatoid arthritis
  • Bacterial infection, including tuberculosis
  • Fungal infection
  • Heart attack
  • HIV/AIDS
  • Injury, trauma or surgery to the chest, esophagus or heart
  • Kidney failure
  • Parasitic infection
  • Radiation therapy to the chest
  • Viral illness

Though rare, the following medications have been known to cause pericarditis:

  • Phenytoin (an anti-seizure medicine)
  • Procainamide (a medicine to treat irregular heartbeats)

Pericarditis can occur repeatedly over many years. Chronic inflammation of the pericardium can cause scarring, a condition known as constrictive pericarditis. With this condition, the layers of the pericardium can become fused together, which restricts the heart from expanding as it fills with blood, causing heart failure symptoms. Diuretics may be prescribed to improve these symptoms.  

Diagnosing Pericarditis

Your doctor will diagnose pericarditis based on a physical exam, your medical history and results from various tests. Using a stethoscope, your doctor will check for sounds that indicate excess fluid in your chest and the “pericardial rub,” a sound that occurs when the pericardium rubs against the outer layer of your heart.

To confirm suspicions, your doctor may recommend any of the following tests:

  • Cardiac CT
  • Chest X-ray
  • Electrocardiography (EKG)
  • Lab testing
  • Magneticresonance imaging (MRI) 
  • Ultrasound testing, such as echocardiography

Treating Pericarditis

Many cases of pericarditis are mild and clear up on their own with rest and medication for pain and inflammation, such as aspirin or ibuprofen. Depending on whether your condition was caused by a bacterial or fungal infection, your doctor may also prescribe an antibiotic or antifungal medication.

If this treatment is ineffective or the condition is more advanced when first diagnosed, it may be treated with intravenous or oral steroids for a short period of time. Other anti-inflammatory medications, such as non-steroidal anti-inflammatory medications or colchicine, are also prescribed individually or in combination with one another.  These medications may be necessary for weeks to months following the initial diagnosis.

Pericarditis can cause fluid to collect in the pericardial sac that surrounds the heart. A large amount of fluid can prevent the heart from filling and squeezing appropriately. This is known as a pericardial effusion, which can be a life-threatening condition. A pericardiocentesis is a procedure that drains the fluid by inserting a needle into the pericardial sac. If this cannot be done, a surgical procedure called a pericardial window is performed.

When pericarditis becomes recurrent or if constrictive pericarditis develops and can’t be controlled with medications, surgery to remove the pericardium may be recommended. This procedure, known as a pericardectomy, is complicated and usually reserved for extreme cases.

Experts in Diagnosing and Treating Pericarditis

The physicians and staff of Aurora Health Care use a multi-disciplinary approach in treating patients with pericarditis. Depending on your specific needs, our team may include cardiologists, cardiac surgeons, infective disease specialists and rheumatologists who collaborate in diagnosing and treating your condition. We also have access to imaging specialists and advanced imaging techniques for diagnosing your condition and guiding treatment strategies.

Aurora doctors are conveniently located throughout eastern Wisconsin and northeastern Illinois. Find a doctor or heart specialist near you. To get a second opinion or if you need assistance finding a provider, please call 888-649-6892.