What is pericarditis?

Pericarditis is a condition in which the pericardium becomes inflamed. The pericardium is the thin membrane that covers the heart. It is made up of tissue that is loose enough to allow the heart to move and change in size. Inflammation of the pericardium can cause chest pain.

How does it occur?

Inflammation of the membrane around the heart can be caused by the following:

• infection

• injury to the heart

• rheumatic fever

• myocardial infarction (heart attack)

• pleurisy

• tuberculosis.

The space between the inner and outer layers of the pericardium may fill with excess fluid, causing pressure on the heart and limiting its ability to pump blood properly. If this condition continues for a long time, the pericardium can become scarred. This may result in a drop in blood pressure, difficulty breathing, swelling in the neck veins, and edema (swelling in the tissues of the legs).

What are the symptoms?

Symptoms of pericarditis include:

• sharp chest pain becoming worse when a deep breath is taken, the body position changes, or coughing begins

• if the back part of the heart covering is inflamed, pain may be felt with swallowing

• fever

• pain decreases when you sit up or lean forward

• feeling that the heart is beating faster than usual

• tiredness

• shortness of breath.

How is it diagnosed?

To diagnose pericarditis, the doctor will examine you, take your medical history, and may order the following tests:

• chest x-ray

• ECG

• cardiac ultrasonography (use of high frequency sound to image the heart)

• blood chemistries

• tuberculin skin tests (when the cause of the pericarditis is not readily defined).

How is it treated?

The treatment is usually aspirin every 3 to 4 hours and/or a nonsteroidal medication. Steroid drugs may be prescribed if pericarditis is a complication of a heart attack, connective tissue disease, or metabolic disorder. These medications calm down the inflammation of the pericardium. You can use nonprescription drugs such as acetaminophen for relief of minor aches and pains. You can also use a heating pad or ice bag on your chest to relieve pain.

If you have a fever:

• Stay in bed if you have a fever above 100 degrees F (37.8 degrees C). After your temperature has fallen below 100 degrees F (37.8 degrees C), become as active as you comfortably can.

• Ask your doctor if you can take aspirin or acetaminophen to control your fever.

• Keep a record of your daily temperature.

How long will the effects last?

Improvement in these conditions will vary from a few days to several weeks.

In severe cases, a pericardectomy is performed. In this surgery an incision is made between the ribs, and the pericardium is removed. Removal of this membranous bag around the heart does not impair the functioning of the heart.

How can I prevent pericarditis from recurring?

Most of the causes are not easily preventable. You can be aware of the symptoms and contact your doctor immediately if they reappear.