PERICARDITIS

Pericarditis is inflammation of the membranous sac (pericardium) that surrounds the heart.

Pericarditis typically causes sharp chest pain & fever.

It is more common in males 30-50 years old.

Most cases are due to a viral infection & the condition usually resolves within a few weeks.

Pericarditis is not a life-threatening condition.

Causes of Pericarditis

Infection with a virus is the most common cause. Several different viruses can cause pericarditis including coxsackie virus, adenoviruses, and the mumps virus.

Other causes of pericarditis are less common & include bacterial infection, kidney failure, metastatic disease, and radiation therapy. It can also occur days or weeks after a heart attack (Dressler syndrome). Pericarditis can also develop in patients with immune system diseases, such as rheumatoid arthritis and lupus.

Some medicines can trigger an immune response that causes pericarditis. These include isoniazid, hydralazine, penicillin, procainamide, and phenytoin.

In idiopathic pericarditis, no clear cause is found.

Symptoms of Pericarditis

Typical symptoms are sharp/stabbing chest pain and fever. The pain is usually in the middle of the chest (behind the breast bone) or under the left ribs.

Pain may be sharp and stabbing, although it can also be a persistent steady pain. The pain may spread to the neck & shoulders.

The pain may get worse when you take a deep breath, cough, swallow, or lie down.

The pain may be eased by sitting up or leaning forward.

Shortness of breath is not a typical symptom of pericarditis, however it may be an indication that fluid has collected around the heart (pericardial effusion).

Diagnosis of Pericarditis

Chest pain that worsens when taking a deep breath or lying down and improves on sitting up and leaning forward suggests pericarditis.

A pericardial rub may be heard by the doctor when he listens to your chest with a stethescope.

Pericarditis frequently produces characteristic findings (elevated, saddle-shaped ST segments) on the electrocardiogram (ECG).

An echocardiogram may be performed to see if there is a pericardial effusion, although it can not diagnose pericarditis.

Treatment of Pericarditis

The main treatment of pericarditis is anti-inflammatory drugs (eg. ibuprofen). These reduce the pain & inflammation associated with pericarditis.

Since most cases of pericarditis are due to a viral infection or are idiopathic, no further treatment is usually required -- the condition usually resolves within a few weeks.

Note: Although pericarditis is not a life-threatening condition, it is important that other, more serious causes of chest pain are excluded. These include myocardial infarction (heart attack), pulmonary embolus (blood clot on the lung), pneumothorax (collapsed lung), and dissection of the aorta. Anyone experiencing chest pain should always seek immediate medical attention to determine the cause.