Marwa is a physician and a medical writer with four years of experience in clinical cardiology.
Adam was a college student who loved sports. On his way home from tennis practice, he started to feel unwell. Over the next five days, he developed symptoms of a cold that got better without medicine.
A week later, on his way out for a jog, he felt stabbing pain in his chest. He got worried that he might be having a heart attack, especially because his father was a cardiac patient. He decided to go to the E.R and get a doctor's opinion.
Adam was relieved; a cardiologist reassured him after doing an examination and some necessary investigations. He told Adam that he had 'pericarditis'.
The doctor asked him to rest and stop training until he recovered. He also gave him painkillers to help with the pain. Four weeks later he had fully recovered and gradually started to return to his training routine.
“Peri” means around, and “cardium” means heart. So, pericarditis means inflammation in the layer surrounding the heart.
Think of the pericardium as a two-layered coat surrounding the heart. Instead of fiber filling in a coat, the two layers of the pericardium are separated by a thin layer of fluid between them. This fluid normally acts as a lubricant and the pericardium protects the heart and keeps it in place.
When an inflammation occurs, this fluid increases causing a pericardial effusion. Inflammation of the pericardium and pericardial effusion cause the signs and symptoms of pericarditis.
In many cases of acute pericarditis, the cause is unknown.
Some identified causes of pericarditis are:
- Viral infections
- Bacterial infections like tuberculosis
- After cardiac surgery or injury by trauma
- Autoimmune diseases like systemic lupus
- Metabolic diseases like kidney failure
If pericarditis starts suddenly and lasts for a short time (usually less than 3 weeks), it is called ‘acute pericarditis’.
If your symptoms start gradually or last for a long time (more than 3 months), it is called ‘chronic pericarditis’.
Common symptoms include:
Chest pain is usually described as ‘stabbing’. However, pain may be crushing, dull aching or merely a sense of fatigue. This pain is usually worse when lying on your back or during coughing. Leaning forwards may decrease your symptoms and pain may extend from your chest to your shoulder.
i.e.: Feeling like your heart is racing
Shortness of breath
i.e.: Feeling like you can’t breathe normally interfering with your everyday activities like walking and talking
Swelling of feet and legs
i.e.: You may notice your shoes become too tight or you see or feel your skin swelling
i.e.: Body temperature between 37.5 c and 38.3 c
If the amount of fluid in the pericardium (called pericardial effusion) increases, the heart is not able to fill with blood and pump normally.
If the increase in fluid prevents the heart from pumping enough blood to meet the demands of the body, cardiac tamponade occurs. This is an emergency condition, and your doctor will drain the excess fluid to allow the heart to pump.
Sometimes the pericardium becomes tough and scarred. This prevents the heart from being able to stretch and causes a condition called constrictive pericarditis. Constrictive pericarditis causes symptoms of heart failure (like shortness of breath and swelling of legs).
Your doctor will ask you some questions and perform a physical examination before doing tests.
They will perform an ECG (Electrocardiogram) to assess the electrical activity of the heart and in some cases--laboratory investigations to identify suspected causes.
Your doctor may also order any of the following imaging tests to allow them to visualize the pericardium, confirm the diagnosis and exclude others causes:
- ECHO (Ultrasound imaging of your heart)
- MRI (Magnetic Resonance Imaging)
- CT scan (Computed tomography)
After seeing your doctor, they will decide if you need to receive treatment in the hospital or at home.
Treatment of pericarditis usually starts with getting enough rest.
Commonly, your doctor will prescribe drugs like pain killers (anti-inflammatory drugs) to help you with the pain and decrease the inflammation like Aspirin, Ibuprofen, Colchicine, and Steroids.
If your doctor identifies a cause for pericarditis, treating it will help treat pericarditis as well.
There are no preventive measures for acute pericarditis. Nonetheless, seeking medical help early and adhering to your treatment plan is important to decrease the risk of recurrence.
If you are concerned about your risk, visit your doctor. Pericarditis generally has a good prognosis and it is possible to have a full active life after an episode of pericarditis.
Phelan, D., Collier, P., & Grimm, R. A. (2015, July). Pericardial Disease. Retrieved March 2020, from http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/pericardial-disease/
Mayo Clinic staff. (2018, March 6). Pericarditis. Retrieved March 2020, from https://www.mayoclinic.org/diseases-conditions/pericarditis/symptoms-causes/syc-20352510
Cleveland Clinic. Pericarditis: symptoms, causes, treatment. Retrieved March 2020, from https://my.clevelandclinic.org/health/diseases/17353-pericarditis
Beckerman, J. (2018, June 1). Pericarditis (Pericardial Disease): Symptoms, Causes, Diagnosis, Treatment. Retrieved March 2020, from https://www.webmd.com/heart-disease/guide/heart-disease-pericardial-disease-percarditis
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2020 Marwa S