Pericarditis

To diagnose pericarditis, a health care provider will usually examine you and ask questions about your symptoms and medical history.

A stethoscope is typically placed on the chest and back to listen to heart sounds. Pericarditis causes a specific sound, called a pericardial rub. The noise occurs when the two layers of the sac surrounding the heart (pericardium) rub against each other.

Blood tests are usually done to check for signs of a heart attack, inflammation and infection. Other tests used to diagnose pericarditis may include:

Electrocardiogram (ECG). An electrocardiogram is a quick and painless test that records the electrical signals in the heart. Sticky patches (electrodes) with wires attached connect to a monitor. They record the electrical signals that make the heart beat. A computer records the information and displays it as waves on a monitor or on paper.

Chest X-ray. A chest X-ray can show changes in the size and shape of the heart. It can help detect an enlarged heart.

Echocardiogram. Sound waves (ultrasound) create images of the moving heart. An echocardiogram can show how well the heart is pumping blood and if there is fluid buildup in the tissue surrounding the heart.

Cardiac computerized tomography (CT) scan. Cardiac CT scans use X-rays to create images of the heart and chest. The test can be used to look for heart thickening that may be a sign of constrictive pericarditis.

Cardiac magnetic resonance imaging (MRI). Cardiac MRI uses a magnetic field and radio waves to create cross-sectional images of the heart. A cardiac MRI scan can reveal thickening, inflammation or other changes in the thin tissue surrounding the heart.

Treatment for pericarditis depends on the cause and the severity of the symptoms. Mild pericarditis may get better without treatment.

Medications

Medications to reduce the inflammation and swelling are often prescribed. Examples include:

Pain relievers. Pericarditis pain can usually be treated with over-the-counter pain relievers, such as aspirin or ibuprofen (Advil, Motrin IB, others). Prescription-strength pain relievers also may be used.

Colchicine (Colcrys, Mitigare). This drug reduces inflammation in the body. It's used to treat acute pericarditis or if symptoms tend to come back. You should not take this drug if you have liver or kidney disease. Colchicine can also interfere with other drugs. Your health care provider will carefully check your health history before prescribing colchicine.

Corticosteroids. Corticosteroids are strong medications that fight inflammation. A corticosteroid such as prednisone may be prescribed if pericarditis symptoms don't get better with other medications, or if symptoms keep returning.

If pericarditis is caused by a bacterial infection, treatment may include antibiotics and drainage, if necessary.