17353 Pericarditis
Informed by recognized medical guidance
Overview
Pericarditis is swelling and irritation of the pericardium, the thin, double-layered sac that surrounds and protects your heart. When this sac becomes inflamed, it can cause sharp chest pain and other symptoms.
Key facts
- Pericarditis is not a heart attack, but the chest pain can feel similar.
- Most cases are mild and improve within a few weeks with rest and treatment.
- It can sometimes come back or lead to complications, so medical follow-up is important.
Pericarditis is not rare. It affects roughly 1 in 1,000 people each year. Many cases get better quickly, but some people need prolonged treatment.
Pericarditis can affect anyone of any age, but it is most often seen in men between the ages of 20 and 50. It can also happen in children, older adults, and people with certain underlying conditions.
Symptoms
- Sudden, severe chest pain that lasts more than a few minutes
- Chest pain with shortness of breath, sweating, nausea, or fainting
- A feeling of pressure or tightness spreading to your arm, neck, or jaw
- Collapse or unconsciousness — call your local emergency number immediately
- ⚠Chest pain that is new, worrying, or keeps coming and going
- ⚠Chest pain with a fever or a cough that is making you very unwell
- ⚠Rapid or irregular heartbeat
- ⚠Dizziness or lightheadedness
- ⚠Symptoms that seem to be getting worse after a diagnosis of pericarditis
Common symptoms
- Sharp chest pain in the middle or left side of the chest, which may feel worse when lying down, coughing, or taking a deep breath
- Pain that eases when sitting up and leaning forward
- Shortness of breath, especially when lying flat
- Low-grade fever and feeling generally unwell
- Fatigue and weakness
- Heart palpitations (feeling like your heart is racing or skipping a beat)
Symptoms in children
- Chest pain or discomfort
- Irritability and unusual fussiness
- Fever
- Fast breathing or difficulty breathing
- Poor feeding or not wanting to play
Symptoms in older adults
- Shortness of breath with little activity
- General weakness and tiredness
- Confusion or mental fogginess
- Less typical chest pain, or sometimes no pain at all
Causes
Main causes
- Viral infections, such as those that cause the common cold or flu
- After a heart attack or heart surgery
- Autoimmune diseases, where the immune system attacks healthy tissue, such as lupus or rheumatoid arthritis
- Kidney failure, which can cause waste products to build up in the body
- Cancer that has spread to the chest
- Radiation therapy to the chest area
- Certain medicines, though this is uncommon
- Sometimes no clear cause can be found — this is called idiopathic pericarditis
Risk factors
- A recent viral infection
- Having had a heart attack or heart surgery
- An autoimmune condition
- Chronic kidney disease
- Being male and aged 20–50
- High levels of stress or heavy alcohol use may also increase the chance
When to see a doctor
See a doctor urgently if:
- Chest pain that is severe, lasts longer than a few minutes, or occurs with sweating, nausea, or breathlessness
- Chest pain that is linked to a high fever or feeling extremely unwell
- Rapid or irregular heartbeat
- Dizziness, lightheadedness, or fainting
Book a routine appointment if:
- Mild chest pain that bothers you even briefly
- Symptoms that have not improved after several days
- A confirmed diagnosis of pericarditis with concerns about how you are recovering
Diagnosis
Your doctor will ask about your symptoms and medical history, and examine you. They will listen to your heart with a stethoscope for a particular sound called a pericardial rub, which is caused by the inflamed pericardium rubbing against the heart. They may also press gently on your chest to find out what makes the pain better or worse.
Tests that may be done
- Blood tests to look for signs of inflammation or infection
- An electrocardiogram (ECG), which checks the electrical activity of your heart
- A chest X-ray to see the size and shape of your heart
- An echocardiogram, an ultrasound scan that shows fluid around the heart and how well the heart is pumping
What to expect at your appointment
If your doctor suspects pericarditis, they may need to do some tests before making a diagnosis. You might have blood tests and an ECG in the same appointment. If the diagnosis is clear, you may be referred to a heart specialist (cardiologist) for more tests, like an echocardiogram. The tests are painless and usually take around 30 minutes.
Treatment
Treatment for pericarditis aims to reduce pain and swelling, treat the underlying cause, and prevent complications. Most people recover at home with rest and medication. Some people, especially those with high-risk features or fluid around the heart, may need to spend time in hospital for close monitoring.
Self-care at home
- Rest as much as possible until your symptoms settle.
- Sit up and lean forward to ease chest pain.
- Use simple pain relief as recommended by your doctor or pharmacist, and always ask first if it is safe for you.
- Drink plenty of fluids to stay hydrated.
- Avoid alcohol and smoking while you recover.
- Take all prescribed medicines exactly as told, and do not stop without speaking to your doctor.
Medical treatments
Doctors often prescribe anti-inflammatory medicines to reduce pain and swelling. In some cases, they may recommend other medicines to stop the inflammation from coming back. If a bacterial infection is the cause, you may need antibiotics. If an autoimmune condition is responsible, you may be referred to a specialist for specific treatment. Always take medicines as prescribed and ask your doctor about any concerns.
When is surgery considered?
In rare cases, pericarditis can cause large amounts of fluid to build up around the heart (pericardial effusion) or make the pericardium stiff and thickened (constrictive pericarditis). If this happens, a doctor may need to drain the fluid with a needle or perform a procedure to remove part of the pericardium. Surgery is only considered when other treatments have not worked or in an emergency.
Living with this condition
During recovery, take things one day at a time. Listen to your body and rest when you feel tired. Avoid heavy lifting, intense exercise, or contact sports until your doctor says it is safe. You may need to take time off from work or school for a few weeks. Most people feel much better within two to six weeks.
Lifestyle tips
- Ease back into daily activities gradually.
- Avoid high-intensity exercise until your doctor gives you the go-ahead.
- Quit smoking and limit alcohol.
- Manage stress with deep breathing or relaxation exercises.
- Keep your vaccinations up to date to prevent infections that can trigger pericarditis.
Diet and exercise
Eat a heart-healthy diet with plenty of fruits, vegetables, whole grains, and lean proteins. If your doctor advises, cut back on salty foods. Exercise is important, but start with short walks and gradually increase your pace. Always check with your doctor before starting a new exercise routine after pericarditis.
Mental health and emotional wellbeing
Living with chest pain and worrying about your heart can be stressful and frightening. It is completely normal to feel anxious, low, or irritable during recovery. Talk to your family or friends about how you are feeling. If low mood or anxiety persists, consider speaking to a mental health professional. You are not alone — support is available.
Prevention
It is not always possible to prevent pericarditis, especially when it is caused by a viral infection or an autoimmune condition. However, practicing good hand hygiene, eating a balanced diet, getting enough sleep, and managing chronic health conditions may reduce your risk.
Vaccines
Keeping up to date with recommended vaccines, such as the flu and COVID-19 vaccines, may help prevent some of the infections that can trigger pericarditis.
Screening programmes
There is no routine screening test for pericarditis in healthy people. If you have symptoms, see a healthcare professional for a thorough evaluation.
Complications
If left untreated
- Pericardial effusion — a buildup of fluid around the heart that can make it hard for the heart to pump normally.
- Cardiac tamponade — a life-threatening emergency where the fluid compresses the heart and prevents it from filling properly.
- Constrictive pericarditis — long-term thickening and scarring of the pericardium, which can restrict the heart's movement.
- Recurrent pericarditis — inflammation that keeps coming back, which can be frustrating and painful.
Long-term outlook
With prompt diagnosis, rest, and the right treatment, most people with pericarditis recover fully. Complications are uncommon, and your healthcare team will monitor you closely to catch any problems early. If the condition returns, there are effective treatments to help. You can go on to live a full and active life.
Find support
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
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Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 31, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.