Inflammation of the pericardium


Pericarditis is inflammation of the pericardium, the protective sac that surrounds your heart. It helps the heart to work properly and holds it in place within the chest.

The pericardium has an inner and outer layer, with a small amount of fluid between which stops the layers from rubbing together as the heartbeats. Pericarditis can occur if blood or excess fluid leaks between the two layers.

What causes pericarditis?

The most common cause of pericarditis is a viral infection, however, there are other, less common causes which include;

  • A heart attack
  • Following a virus or bacterial infection
  • Another inflammatory condition (such as rheumatoid arthritis)
  • A problem with your metabolism, such as kidney failure or under-active thyroid (hypothyroidism)
  • Certain types of cancer, especially breast cancer and lung cancer
  • Reactions to certain medicines
  • Radiotherapy on your chest
  • An injury to your chest from an accident or surgery
  • Inflammation of the myocardium (the heart muscle) rubbing against the pericardium

What are the symptoms of pericarditis?

The main symptom of pericarditis is a pain in your chest. The pain is usually constant and is similar to a stabbing sensation, which may feel worse when swallowing. You may find that the pain spreads to your neck and shoulders (especially the left shoulder) and/ or arms.

Other symptoms may include;

  • An intermittent fever
  • Nausea
  • Lightheadedness
  • Shortness of breath, which may come on suddenly (if this occurs seek urgent medical attention)
  • Feeling weak
  • How is pericarditis diagnosed?

  • Your consultant will ask you about your symptoms and examine you. The tests for pericarditis can include; blood tests (to check for signs of inflammation), an electrocardiogram (ECG) (measures the electrical activity of your heart), a chest x-ray (to see if inflammation has caused a large amount of fluid to build up in the pericardium), an echocardiogram (ultrasound of the heart), a CT scan or MRI scan, and an examination of the pericardial fluid.
  • How is pericarditis treated?

  • Most people with pericarditis get better within days or weeks without any treatment. However, you may need treatment for the symptoms or to prevent complications. Usually, you would be prescribed anti-inflammatory painkillers, for example, Ibuprofen for one or two weeks. If the condition persists, you may be given stronger medication, steroids or antibiotics if the infection is bacterial.
  • On rare occasions, pericarditis can lead to a significant pericardial effusion (a build-up of fluid around the heart), which may require surgery. A pericardial window (a procedure to drain the sac surrounding the heart) is usually performed to treat and permanently prevent symptoms from persisting or coming back.