What is pericarditis?

Pericarditis is an infection of the pericardium the thin, tough bag-like membrane surrounding the heart. Pericarditis can be acute (sudden) or chronic (develop over a long period).

Acute pericarditis may be caused by a bacterial, viral or fungal infection, or by rheumatic fever, rheumatic arthritis, systemic lupus, erythematos, kidney failure, sclerodema or tumours. It may also develop as a result of heart attack, heart surgery, serious chest injury or using certain medications that suppress your immune system. Although rare, chronic pericarditis may be caused by a chronic infection such as tuberculosis.

Types of pericarditis

Acute fibrinous pericarditis the pericardium is inflamed and covered with a layer of material called fibrin

Acute purulent pericarditis the pericardium is covered with thick pus

Acute constrictive pericarditis the pericardium is covered with a dense mass of calcified fibrosis material

Chronic pericarditis caused by a long-term infection such as tuberculosis

Symptoms
Pericarditis may cause chest pain, sometimes described as sharp and severe, and sometimes as aching and overwhelming.

Diagnosis
To diagnose pericarditis, your doctor will usually take a detailed medical history and listen to your heart during a physical exam. If you have pericarditis, your doctor may hear what is called a pericardial rub a scratchy or grating noise, when he/she listens to your heart with a stethoscope. This can often be heard in just a small area but can change position, and is usually accentuated if you lean forward and hold your breath.

Other tests that may be done include:

Blood tests
Cardiac catheterization
Chest X-ray
Electrocardiogram (ECG/EKG)

Treatment
If you have pericarditis that results from an allergy or virus you will usually recover within a few weeks. Otherwise, your doctor may prescribe medication or recommend surgery. You may also need to make lifestyle changes

Medication
If your pericarditis resulted from a bacterial infection, you may be treated with antibiotics. Analgesics (pain killers) may be given to ease the pain. Anti-inflammatory medications or steroids may also be prescribed to reduce inflammation.

Surgery
If drug treatment fails, pericardial resection surgery may be necessary to remove thickened pericardium or to drain accumulated fluid.

Lifestyle
You can lower your risk of heart disease by knowing and controlling your blood pressure, diabetes and blood cholesterol. It is also important to lead a healthy lifestyle by being smoke-free and physically active, eating a healthy diet that is lower in fat, especially saturated and trans fat, achieving and maintaining a healthy weight, limiting alcohol use and reducing your stress.