Pericarditis

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Overview

Pericarditis can be attributed to several factors, including viral, bacterial, fungal and other infections. Other possible causes of pericarditis include heart attack or heart surgery, other medical conditions, injuries and medications.

Pericarditis can be acute, meaning it happens suddenly and typically doesn’t last long. Or the condition may be "chronic," meaning that it develops over time and may take longer to treat.

Both types of pericarditis can disrupt your heart’s normal function. In rare cases, pericarditis can have very serious consequences, possibly leading to abnormal heart rhythm and death.

Symptoms

Pericarditis symptoms include chest pain that:


Is sharp and stabbing (This happens when your heart rubs against your pericardium).

May get worse when you cough, swallow, take deep breaths or lie flat.

Feels better when you sit up and lean forward.

You also may feel the need to bend over or hold your chest to breathe more comfortably.


Other pericarditis symptoms include:


Pain in your back, neck or left shoulder.

Trouble breathing when you lie down.

A dry cough.

Palpitations (feeling like your heart is racing or beating irregularly).

Anxiety or fatigue.

Fever.

Swelling of your legs, feet and ankles in severe cases.

Swelling in your feet, legs and ankles or shortness of breath every time you exert yourself may be a symptom of constrictive pericarditis. This is a severe type of pericarditis where the pericardium gets hard and/or thick. When this happens, the heart muscle can’t expand, which keeps your heart from working as it should. Your heart can become compressed, which makes blood back up into your lungs, abdomen and legs, leading to swelling and causing symptoms of congestive heart failure. You can also develop an abnormal heart rhythm.

Causes

Viruses are the most common causes of pericarditis. The incidence of pericarditis is also slightly higherTrusted Source in the African American population, according to a 2017 review.


Other infectious causes include:


bacterial infection

fungal infection

parasitic infection

Noninfectious causes include:


cardiovascular issues, like a previous heart attack or surgery

tumors impinging on the pericardium

injuries

radiation treatment

autoimmune conditions, like lupus

some medications, which is rare

metabolic disorders, like gout

kidney failure

some genetic diseases, like familial Mediterranean fever

Risk factors

A past heart attack.

Autoimmune diseases.

Trauma or injury from an accident.

Certain bacterial, viral and fungal infections.

Kidney failure.

Rarely, certain medications such as phenytoin to treat seizures and procainamide to treat irregular heartbeats.

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Complications

Early diagnosis and treatment of pericarditis usually reduces the risk of complications. Potential complications of pericarditis include:


Fluid buildup around the heart (pericardial effusion). The fluid buildup can lead to further heart complications.

Thickening and scarring of the heart lining (constrictive pericarditis). Some people with long-term pericarditis develop permanent thickening and scarring of the pericardium. The changes prevent the heart from filling and emptying properly. This unusual complication often leads to severe swelling of the legs and abdomen and shortness of breath.

Pressure on the heart due to fluid buildup (cardiac tamponade). This life-threatening condition prevents the heart from filling properly. Less blood leaves the heart, causing a dramatic drop in blood pressure. Cardiac tamponade requires emergency treatment.

Prevention

There’s no conclusive way to prevent pericarditis, especially cases of viral pericarditis. But if you experience pericarditis, following your treatment plan and using colchicine, and avoiding corticosteroids, may reduce the risk of it recurring.

Until you fully recover, rest and avoid strenuous physical activity. Discuss with your doctor how long you should limit your activity.

If you see any signs of recurrence, check with your doctor as soon as possible.