Pericarditis is an inflammation of the pericardium, the protective sac surrounding the heart that helps cushion it from surrounding structures. The pericardium has two layers, which are separated by a small amount of fluid. When these layers become inflamed, they can rub against the heart, and cause chest pain, which can be mistaken for a heart attack. Pericarditis is classified as either chronic or acute.

Causes of Pericarditis

In most cases of pericarditis, the cause cannot be determined, although viral infections are thought to be the main culprits. Other possible causes include the following:

  • Heart attack or heart surgery
  • Injury to the heart
  • Systemic inflammatory disorders
  • Kidney failure
  • HIV/AIDS infection
  • Cancer
  • Tuberculosis
  • Bacterial or fungal infection

In rare instances, some medications cause pericarditis.

Symptoms of Pericarditis

Depending on whether pericarditis is chronic or acute, symptoms vary. The most common symptom of acute pericarditis is sharp chest pain. Other symptoms of acute pericarditis include the following:

  • Fever
  • Weakness
  • Heart palpitations
  • Coughing
  • Trouble breathing

Symptoms of chronic pericarditis include the following:

  • Tiredness
  • Coughing
  • Shortness of breath
  • Swelling of the stomach and legs
  • Low blood pressure

In some cases of acute pericarditis, rather than sharp chest pain, a dull ache or pressure is felt.

Diagnosis of Pericarditis

To diagnose pericarditis, a medical history is taken, and a complete physical exam performed. Pericarditis can be detected stethoscopically: The pericardium can actually be heard rubbing against the heart. The following additional tests may be performed:

  • Electrocardiogram (EKG)
  • Chest X-ray
  • Cardiac CT scan
  • Cardiac MRI scan
  • Echocardiogram
  • Blood tests

Although pericarditis can affect a person at any age, the majority of cases are seen in men between 20 and 50 years old.

Treatment for Pericarditis

Mild cases of pericarditis often clear up on their own, without treatment, although patients are advised to get plenty of rest. Drugs used to treat pericarditis include the following:

  • Over-the-counter anti-inflammatory medication
  • Colchicine (prescription anti-inflammatory)
  • Antibiotics
  • Corticosteroids

In more severe cases, pericardiocentesis may be performed to remove excess fluid within the pericardium. The most severe cases may require pericardiectomy, the removal of the pericardium.

Untreated pericarditis can become chronic, and can even lead to life-threatening heart problems.

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