Pericarditis: What You Need to Know

Medically Reviewed By Angelica Balingit, MD
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Pericarditis is inflammation of the pericardium, the sac that surrounds the heart. Symptoms can include chest pain and fever. In many cases, pericarditis is mild and resolves quickly. However, in some cases, it can become chronic and take longer to treat. Treatment varies based on the underlying cause but can include medications such as ibuprofen, colchicine, steroids, and antibiotics. In some cases, doctors may need to drain fluid around the heart or remove the pericardium entirely.

Read on to learn more about the types, causes, symptoms, and treatments for pericarditis.

Sex and gender terms

Sex and gender exist on spectrums. For the purposes of this article, we use “male” to refer to a person’s sex assigned at birth.

What are the types of pericarditis?

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Researchers describe four general subtypes of pericarditis.

Acute

Acute pericarditis develops suddenly and typically last for less than 4–6 weeks. According to the American Heart Association (AHA), up to 30% of people with acute pericarditis will experience a recurrence.

Subacute or incessant

Subacute pericarditis typically persists for longer than 4–6 weeks but does not exceed 3 months.

Chronic

Chronic pericarditis persists for more than 3 months with no break in symptoms. There are two forms of chronic pericarditis: chronic effusive and chronic constrictive.

Chronic effusive pericarditis occurs when fluid gradually builds up in the pericardium. Chronic constrictive pericarditis occurs when long-term inflammation causes the pericardium to scar and thicken.

Recurrent

Recurrent pericarditis occurs when pericarditis symptoms reappear following 4–6 weeks of no symptoms.

What are the causes of pericarditis?

In some cases, it can be difficult to determine the cause of pericarditis. However, viral infections are often a contributing factor.

Researchers generally split the causes of pericarditis into two categories: infectious and noninfectious. Possible infectious causes include:

  • respiratory infection
  • digestive system infection
  • viral infections
  • tuberculosis
  • HIV

Noninfectious causes of pericarditis can include:

  • heart attack
  • heart surgery
  • injuries from accidents
  • radiation therapy
  • kidney failure
  • cancer
  • autoimmune disorders, such as rheumatoid arthritis, lupus, or scleroderma
  • certain medications, such as:
    • warfarin (Jantoven, Coumadin)
    • heparin (Lovenox, Fragmin)
    • phenytoin (Phenytek, Dilantin Infatabs)
    • procainamide (Pronestyl, Procanbid)

What are the symptoms of pericarditis?

One of the most common symptoms of acute pericarditis is chest pain. The pain is usually sharp and sudden and may worsen when you breathe deeply or lie down.

Other acute pericarditis symptoms can include:

For the other types of pericarditis, symptoms may also include:

If you have sudden chest pain with weakness, shortness of breath, and sweating, seek immediate medical care or call 911. These symptoms could indicate a heart attack.

How do doctors diagnose pericarditis?

In addition to assessing your medical history and performing a physical examination, your doctor will likely order the following tests:

  • ECG: This test helps doctors assess your heart’s electrical activity.
  • Echocardiography: Doctors can use sound waves to evaluate your heart’s size, shape, and function.
  • Chest X-ray: X-rays can show if you have an enlarged heart, which could indicate fluid buildup.
  • Blood tests: Doctors use these tests to determine the presence of inflammation or injury to the heart muscles.

If one or more of the above tests are inconclusive, doctors may order additional imaging tests. These include:

  • Cardiac CT scan: This scan creates detailed images of your heart.
  • Cardiac MRI scan: This scan can help doctors determine if your pericardium has changed.

What are the treatments for pericarditis?

Treatment for pericarditis will typically begin with restricting physical exertion until symptoms resolve and the inflammation decreases. Doctors may then recommend medications or certain medical procedures.

Medications

Your doctor may recommend over-the-counter (OTC) or prescription medications to treat pericarditis, including:

  • pain relievers, such as ibuprofen or aspirin
  • colchicine, an anti-inflammatory medication
  • steroids
  • antibiotics, if the cause is a bacterial infection

In 2021, the Food and Drug Administration (FDA) approved a drug called rilonacept to treat recurrent pericarditis and reduce recurrence risk in people 12 years and older.

Other procedures

If there is excess fluid around your heart, your doctor may perform a pericardiocentesis. This procedure involves draining the fluid using a sterile needle or catheter.

Your doctor may also perform a pericardiectomy, which is surgery to remove the pericardium. This procedure may be necessary if the pericardium is scarred and rigid.

What is the outlook for people with pericarditis?

The outlook for people with pericarditis is typically very good, and most people recover completely. However, pericarditis recovery may take longer in more serious cases, particularly if it recurs.

It is important to seek prompt treatment for pericarditis to reduce the risks of recurrence and serious complications.

What are some potential complications of pericarditis?

There are a few potential complications if pericarditis remains untreated:

  • Pericardial effusion: This condition occurs when fluid collects around the heart, which could lead to cardiac tamponade.
  • Cardiac tamponade: If fluid continues to build up, it could put pressure on the heart, preventing it from filling properly. This condition requires immediate medical attention.
  • Constrictive pericarditis: If symptoms persist, the pericardium could scar and thicken to the point where it becomes rigid.

What are the risk factors for pericarditis?

Some factors can increase your risk of developing pericarditis:

Can you prevent pericarditis?

Pericarditis resulting from noninfectious causes may not be preventable. However, following these tips could help minimize the possibility of getting pericarditis from infectious causes:

  • Avoid people who are sick.
  • Maintain good hygiene by washing your hands frequently for at least 20 seconds.
  • Keep up-to-date with recommended vaccines, such as the flu vaccine.

Receiving prompt treatment and following your doctor’s treatment plan can also help prevent recurring episodes.

Other frequently asked questions

These are a few other commonly asked questions about pericarditis. Dr. Angelica Balingit has medically reviewed the answers.

Is pericarditis life threatening?

Pericarditis can be life threatening without prompt treatment. Not receiving treatment can result in serious conditions, such as cardiac tamponade and pericardial effusion. If you are experiencing symptoms consistent with pericarditis, talk with your doctor right away.

Will pericarditis go away?

Pericarditis can be mild and go away on its own. However, it is a good idea to talk with your doctor even if your symptoms are mild.

Can COVID-19 cause acute pericarditis?

Some studies suggest acute pericarditis can result from COVID-19 infection. Talk with your doctor if you suspect you have either COVID-19 or pericarditis.

Summary

Pericarditis is the inflammation of the pericardium, which is the sac surrounding the heart. Common symptoms include chest pain and fever. While it is not always clear what causes pericarditis, viral infections are often a contributing factor. Bacterial infections, autoimmune disorders, and cancer can also cause pericarditis.

Doctors will typically recommend anti-inflammatory medications and OTC pain relievers to treat pericarditis. Antibiotics may be necessary for a bacterial infection. Doctors may need to drain excess fluid from around the heart or remove the pericardium in more serious cases.

If you are experiencing symptoms consistent with pericarditis, talk with your doctor. They can help you diagnose the cause and develop a treatment plan.

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Medical Reviewer: Angelica Balingit, MD
Last Review Date: 2022 May 25
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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