Pericarditis

Pericarditis is inflammation of the pericardium. The pericardium is a thin, protective, sac-like structure with two thin layers of tissue that surround the heart to hold it in place and help it work properly. It has two layers, with a lubricating fluid between the layers. Normally the layers can move against each other without friction. An inflamed pericardium, however, causes pain, irritation and swelling.

Pericarditis can be acute, meaning it happens suddenly and typically doesn’t last long. Or the condition may be "chronic," meaning that it develops over time and may take longer to treat. Both types of pericarditis can disrupt your heart’s normal function. In rare cases, pericarditis can have very serious consequences, possibly leading to abnormal heart rhythm and death.

Pericarditis affects people of all ages, but men ages 16 to 65 are more likely to develop it. Among those treated for acute pericarditis, up to 30% may experience the condition again, with a small number eventually developing chronic pericarditis.

Symptoms

Chest pain is the most common symptom of pericarditis. People describe it as sharp, stabbing or severe, and sometimes as aching and overwhelming. It usually occurs on the left side of the chest and can radiate to the left shoulder and neck.

Other symptoms may include:

  • Increased pain as you breathe in
  • increased pain when you lie down
  • Heart palpitations
  • Difficulty breathing
  • Flu-like symptoms – fever, fatigue, weakness
  • Cough
  • Abdominal swelling
  • Leg swelling

Seek medical care immediately if you have chest pain that is new, worsening or constant.

Causes

Pericarditis may be caused by:

  • Bacterial, viral or fungal infection
  • Rheumatic fever
  • Rheumatoid arthritis
  • Systemic lupus erythematous
  • Kidney failure
  • Scleroderma
  • Tumours
  • Heart attack
  • Heart surgery
  • Serious chest injury
  • HIV/AIDS
  • Tuberculosis
  • Certain medications that suppress the immune system
  • More recently, some patients receiving MRNA vaccines for COVID-19, such as the Pfizer and the Moderna vaccines have presented with pericarditis, although the risk of developing this complication is very low.
Treatment

Pericarditis is frequently mild and may clear up on its own with rest or simple treatment. More serious cases may be treated with medication. Early diagnosis and treatment of pericarditis can help to prevent complications.

Although pericarditis doesn’t increase your risk for other types of coronary heart disease, it is still important to control your blood pressure, diabetes and blood cholesterol, and lead a healthy lifestyle.

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