Pericarditis is swelling and irritation of the thin, saclike tissue surrounding your heart (pericardium). Pericarditis often causes sharp chest pain and sometimes other symptoms. The chest pain occurs when the irritated layers of the pericardium rub against each other.
Pericarditis is usually mild and goes away without treatment. Treatment for more-severe cases may include medications and, rarely, surgery. Early diagnosis and treatment may help reduce the risk of long-term complications from pericarditis.
Chest pain is the most common symptom of pericarditis. It usually feels sharp or stabbing. However, some people have dull, achy or pressure-like chest pain.
- The pain usually occurs behind the breastbone or in the left side of your chest.
- It may spread to your left shoulder and neck.
- It often gets worse when you cough, lie down or take a deep breath.
- Sitting up and leaning forward makes you feel better.
Other signs and symptoms of pericarditis may include:
- Abdominal or leg swelling
- Fatigue or general feeling of weakness or being sick
- Low-grade fever
- Pounding or racing heartbeat (heart palpitations)
- Shortness of breath when lying down
The specific symptoms you have depend on the type of pericarditis you have. Pericarditis is grouped into different categories, according to the pattern of symptoms and how long symptoms last.
- Acute pericarditis begins suddenly but doesn't last longer than three weeks. Future episodes can occur. It may be difficult to tell the difference between acute pericarditis and pain due to a heart attack.
- Recurrent pericarditis occurs about four to six weeks after an episode of acute pericarditis with no symptoms in between.
- Incessant pericarditis lasts about four to six weeks but less than three months. The symptoms are continuous.
- Chronic constrictive pericarditis usually develops slowly and lasts longer than three months.
When to see a doctor
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).
The cause of pericarditis is often hard to determine. Sometimes, doctors can't find a cause (idiopathic pericarditis).
Pericarditis causes can include:
- Heart attack or heart surgery, which may trigger pericarditis or delayed pericarditis (Dressler's syndrome, also called postmyocardial infarction syndrome or postcardiac injury syndrome)
- Systemic inflammatory disorders, including lupus and rheumatoid arthritis
- Trauma, such as injury to your heart or chest as a result of a motor vehicle or other accident
- Other health disorders, including kidney failure, AIDS, tuberculosis and cancer
Early diagnosis and treatment of pericarditis usually reduces the risk of the long-term complications. Complications of pericarditis include:
- Pericardial effusion. Pericarditis is usually associated with fluid around the heart, which can lead to more serious complications.
- Chronic constrictive pericarditis. Some people with long-term (chronic) pericarditis develop permanent thickening and scarring of the pericardium, which prevents the heart from filling and emptying properly. This unusual complication often leads to severe swelling of the legs and abdomen and shortness of breath.
- Cardiac tamponade. This life-threatening condition can develop when too much fluid collects in the pericardium. Excess fluid puts pressure on the heart and doesn't allow it to fill properly. Less blood leaves the heart, causing a dramatic drop in blood pressure. Cardiac tamponade requires emergency treatment.