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pericarditis

overview

Pericarditis occurs when the pericardium, the sac that surrounds your heart, becomes red, swollen and inflamed. It can affect people of all ages, but men ages 20 to 50 are more likely to develop it than others.

In many cases, the cause of pericarditis remains unknown. However, some things are known to trigger pericarditis. They include autoimmune diseases, bacterial and fungal infections, kidney failure and viruses.

Though a reaction is rare, medications such as phenytoin (an anti-seizure medicine) and procainamide (a medicine to treat irregular heartbeats) have been known to cause pericardium.

symptoms

The primary symptoms of pericarditis are 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 symptoms include:

  • Fever
  • Weakness
  • Heart palpitations
  • Trouble breathing
  • Dry cough
If chronic pericarditis becomes severe, signs 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.

diagnosis

Your doctor will diagnose pericarditis based on a physical exam, your medical history and results from various tests. Your doctor may also recommend the following tests:

services & treatment

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. Your doctor may also prescribe an antibiotic or antifungal medication. If this treatment is ineffective or if the condition is more advanced when first diagnosed, you may need:

  • Intravenous or oral steroids 
  • Other anti-inflammatory medications
  • Pericardiocentesis – a procedure to remove fluid from the pericardium, the sac that surrounds the heart
  • Pericardectomy – a procedure to remove the pericardium entirely, usually reserved for extreme cases.

related conditions

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.

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