Pericarditis or Pericardial Disease

Pericarditis or Pericardial Disease

What is it?

Pericarditis is a swelling and irritation of the pericardium, the thin sac-like membrane that surrounds the major blood vessels of the heart. The inner layer of the pericardium is attached to the heart muscle. When pericarditis occurs, the amount of fluid in the layers of the pericardium increases and presses on the heart which restricts the pumping action.

Causes, Symptoms and Risk Factors

The cause is often hard to determine but may be from conditions such as:

  • Viral infection
  • Heart attack
  • Heart surgery
  • Trauma or injury to the heart or chest
  • Kidney failure
  • Cancer
  • AIDS
  • Tuberculosis
  • Medicines

Additionally, pericarditis could occur weeks after a heart attack or heart surgery due to the formation of antibodies and the body’s autoimmune response to them. This is called Dressler’s Syndrome.

Pericarditis is classified as acute or chronic. Acute pericarditis lasts only one to two weeks. Chronic pericarditis can last for six months or more.

Symptoms of acute pericarditis are similar to those of a heart attack which include:

  • Sharp, stabbing chest pain behind the breastbone or left side of chest
  • Dull, achy pressure-like pain
  • Pain in left shoulder or neck

Sitting and leaning forward often eases the pain. It may intensify when the following occurs:

  • Lying Down
  • Inhaling deeply
  • Coughing
  • Taking a deep breath
  • Swallowing food

Chronic pericarditis is often linked to pericardial effusion. Often painless, the most common symptom is shortness of breath but depending on the type, symptoms may include:

  • Sharp, stabbing chest pain behind the breastbone or left side of chest
  • Shortness of breath when reclining
  • Low-grade fever
  • Sense of feeling sick
  • Weakness
  • Fatigue
  • Dry cough
  • Swelling (edema) of the legs or abdomen

Chronic pericarditis may lead to constrictive pericarditis. This condition occurs when the pericardium loses its elasticity from permanent thickening, scarring and contraction of the pericardium. It results in shortness of breath and severe edema in the legs and abdomen.

Another risk is when too much fluid collects in the pericardium, a condition called cardiac tamponade can develop. This condition can cause a drastic drop in blood pressure due to excess fluid on the heart and can be fatal.

Our Services (Tests, Procedures and Treatments)

Diagnostic testing and procedures are the first step in establishing a treatment strategy. A doctor may order tests or perform the following procedures:

Early diagnosis and treatment of pericarditis usually reduces the risk of long-term complications. Mild cases may get better without treatment. If treatment is necessary, it may include:

  • Rest
  • Nonsteroidal anti-inflammatory medicine
  • Corticosteroid medicine such as prednilisone
  • Antibiotics if caused by an infection

If constrictive pericardiocentis develops, a pericardiectomy may need to be performed to remove the entire pericardium.

If cardiac tamponade develops, pericardiocentis may be performed to remove and drain excess fluid from the pericardial area.

St. Luke's Heart & Vascular