PERICARDITIS, ACUTE

General Information

DEFINITION--Inflammation of the pericardium (thin membrane around the heart). This is not contagious or cancerous, unless caused by the spread of cancer elsewhere.

BODY PARTS INVOLVED--Pericardium.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS

• Dull or sharp pain in the front of the chest, radiating to the neck and shoulder. The pain worsens with movement and eases when sitting up or leaning forward.
• Rapid breathing.
• Cough.
• Fever and chills.
• Weakness.
• Anxiety.
• The most important signs are apparent only with medical examination.

CAUSES--

Sometimes unknown. The most common known causes are:

• Viral, bacterial, tuberculous, amebic, toxoplasmosis or fungal infection.
• Rheumatic fever and other diseases of connective tissue, such as lupus erythematosus.
• Chronic kidney failure.
• Complication of a heart attack.
• Complication following heart surgery.
• Complication of a chest injury, including use of a cardiac catheter.
• Spread of cancer to the pericardium.
• Drug induced.
• Radiation therapy.

RISK INCREASES WITH

• Recent illness, such as a heart attack, viral illness or rheumatic fever.
• Medical history of tuberculosis.

HOW TO PREVENT--No specific preventive measures except medical treatment of the disorders that cause pericarditis.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Diagnostic tests may include chest x-ray, chest CT scan or MRI, ECG, echocardiogram, heart catheterization (See Glossary for all).
• Pericardiocentesis (fluid removal from the pericardial sac) may be diagnostic or therapeutic (for complications).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Surgery (sometimes) to remove fluid through a needle if fluid collects in the pericardium.
• Self-care.

POSSIBLE COMPLICATIONS

• Chronic pericarditis.
• Recurrence.
• Pericardial effusion (fluid in the pericardial sac).
• Cardiac tamponade (effusion that impairs heart function).

PROBABLE OUTCOME--Usually curable in 6 months unless pericarditis is caused by cancer. After cure, there should be no functional disability.

How To Treat

GENERAL MEASURES--

• Home care is usually sufficient, unless there are complications. Treatment is aimed at relieving symptoms and managing the underlying disease.
• Apply a heating pad or warm compresses to the chest to relieve pain.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Anti-inflammatory therapy with aspirin.
• Steroid drugs for severe forms of pericarditis.
• Stronger pain medications (if aspirin doesn't control the pain).
• Antibiotics, if bacterial infection present.
• Amphotericin B, if fungal infection present.
• Antitubercular drugs, if tuberculous pericarditis.

ACTIVITY--

• Rest in bed until fever and pain subside.
• Resume your normal activities gradually.
• Resume sexual relations when fever and pain disappear.

DIET--No special diet. Ask your doctor about a weight loss diet if you are overweight.

Call Your Doctor If

• You have symptoms of pericarditis.
• The following occurs during treatment: Fever. Shortness of breath and rapid heartbeat. Cough with blood. Unexplained weight loss. Pain not controlled by acetaminophen.
• New, unexplained symptoms develop. Steroids used in treatment may produce side effects, especially restlessness.