Pericarditis

Pericarditis can result from a viral infection. It can also be caused by a major heart attack if the heart muscle and pericardium become irritated. This is called Dressler's syndrome.

Other possible causes include the following:

• Rheumatoid arthritis, lupus or other systemic inflammatory disorders
• Chest trauma
• Medications
• Other medical conditions, including kidney failure, AIDS, tuberculosis and some types of cancer
  
  

Pericarditis symptoms may be localized to your chest (local) or felt throughout your body (systemic).

Local symptoms of pericarditis:

• Sharp pain behind the breastbone or on left side of the chest
• Shortness of breath, especially when laying down
  
  

Localized pericarditis symptoms are very similar to that of a heart attack, so it’s important to seek immediate medical attention if you are experiencing these symptoms.

Systemic symptoms of pericarditis:

• Low-grade fever
• Weakness or fatigue
• Dry cough
• Swelling in the legs or abdomen
  
  

If pericarditis is suspected, your doctor will use a stethoscope to listen for pericardial rub — the sound made if two inflamed layers of your pericardium are rubbing against one another. A diagnosis is confirmed by tests that look for signs of inflammation, fluid around the heart or infection.

To identify and rule out other causes that may contribute to your symptoms, one or more type of imaging is often used:

• Electrocardiogram (ECG/EKG)
• Chest X-ray
• Echocardiogram
• CT coronary angiogram (CTA)
• Cardiac MRI
  
  

Acute pericarditis that is mild and not causing significant symptoms can often be treated using a watchful waiting approach. In some cases, anti-inflammatory medications may be used to reduce the inflammation.

If pericarditis causes fluid accumulation around your heart (pericardial effusion), this fluid buildup must be closely monitored. If it becomes excessive — a complication known as cardiac tamponade — a procedure called pericardiocentesis is required.

For severe cases of chronic constrictive pericarditis, surgical removal of the pericardium, called a pericardiectomy, may be needed.