Pericarditis

Overview

Pericarditis is swelling and irritation of the thin, sac-like tissue that surrounds your heart, called the pericardium. This condition can cause sharp chest pain and other symptoms.

Pericarditis is a common condition, especially in young and middle-aged adults. Most cases are mild and treatable.

People of all ages can get pericarditis, but it is most common in men between the ages of 20 and 50. It can also affect people with certain medical conditions, such as autoimmune diseases or after a heart attack.

Symptoms

Common symptoms

• Sharp chest pain in the center or left side of the chest that may spread to the left shoulder, neck, or arm.
• Pain that gets worse when you take a deep breath, cough, or lie flat.
• Pain that improves when you sit up and lean forward.
• Low-grade fever (temperature up to 38°C / 100.4°F).
• Feeling tired or unwell (malaise).
• Shortness of breath, especially when lying down.

Symptoms in children

• Chest pain with breathing or activity (children may not be able to describe it clearly).
• Irritability or fussiness.
• Trouble feeding or loss of appetite.
• Fever.

Symptoms in older adults

• Chest pain that may feel more like dull pressure than sharp stabbing.
• Fatigue and weakness.
• Shortness of breath.
• Fever may be lower or absent.

Causes

Main causes

• Viral infections, such as colds, flu, or COVID-19.
• Bacterial infections (less common).
• After a heart attack (Dressler syndrome) or heart surgery.
• Autoimmune diseases like lupus or rheumatoid arthritis.
• Chest injury (such as after a car accident).
• Certain medications (rare).

Risk factors

• Recent viral illness or respiratory infection.
• History of autoimmune disease.
• Recent heart attack or heart surgery.
• Dialysis for kidney failure (less common).
• Having cancer that spreads to the pericardium.

When to see a doctor

See a doctor urgently if:

• If you have new chest pain — especially if it is severe, comes on suddenly, or is accompanied by shortness of breath.
• If you have a fever with chest pain.
• If you have a history of heart disease and develop chest pain.

Book a routine appointment if:

• If you have mild chest discomfort that comes and goes, especially when you take a deep breath or lie down.
• If you have been diagnosed with pericarditis before and symptoms return.

Diagnosis

Your doctor will ask about your symptoms and medical history, listen to your heart with a stethoscope (you may hear a scratching sound called a friction rub), and order tests to check for signs of inflammation and rule out other heart problems.

Tests that may be done

• Electrocardiogram (ECG/EKG) — looks for electrical changes typical of pericarditis.
• Blood tests — check for markers of inflammation (like C-reactive protein) and heart enzymes.
• Chest X-ray — shows if the heart is enlarged due to fluid.
• Echocardiogram (ultrasound of the heart) — checks if fluid has built up around the heart.

What to expect at your appointment

Most tests are quick and painless. You may need to go to a hospital or clinic for them. Your doctor will explain what each test is for and what the results mean.

Treatment

Treatment focuses on reducing inflammation and pain, and addressing the underlying cause. Many cases improve with rest and medication. Your doctor will decide the best plan based on your symptoms and test results.

Self-care at home

• Rest and avoid heavy activity or exercise until your doctor says it is safe.
• Use over-the-counter anti-inflammatory medicines (like ibuprofen) only after checking with your doctor — do not take if you have certain medical conditions (like stomach ulcers or kidney problems).
• Apply a heating pad or ice pack to the chest for comfort.

Medical treatments

Doctors usually prescribe anti-inflammatory medications to reduce swelling and pain. These may include nonsteroidal anti-inflammatory drugs (NSAIDs) and sometimes colchicine to prevent recurrence. If the cause is bacterial, antibiotics are given. For cases that do not respond, corticosteroids may be used. Always take medications exactly as prescribed.

When is surgery considered?

Surgery is rarely needed. It may be necessary if fluid builds up around the heart (pericardial effusion) and causes serious pressure (cardiac tamponade). In that case, a needle or tube is used to drain the fluid. For chronic constrictive pericarditis (scarring), surgery to remove part of the pericardium (pericardiectomy) may be considered.

Living with this condition

Most people recover from pericarditis within a few weeks to months. During recovery, it is important to rest and gradually return to normal activities. Follow your doctor’s advice about when to resume work, exercise, and other activities.

Lifestyle tips

• Avoid smoking and limit alcohol.
• Manage stress through relaxation techniques, gentle activities, or talking to a counselor.
• Get plenty of sleep to help your body heal.

Diet and exercise

Eat a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins. Avoid heavy or greasy meals that can cause discomfort. Start with light exercise like walking, and increase intensity only when your doctor says it is safe.

Mental health and emotional wellbeing

Chest pain and a new diagnosis can cause worry or anxiety. It is normal to feel concerned, but remember that pericarditis is usually treatable. Talk to your doctor or a mental health professional if you feel overwhelmed or anxious about your heart health.

Prevention

Pericarditis cannot always be prevented, but you can reduce your risk by treating infections promptly, managing chronic conditions like autoimmune diseases, and avoiding chest injuries when possible.

Vaccines

Vaccines against flu and COVID-19 may reduce the chance of getting viral infections that can lead to pericarditis. Talk to your doctor about recommended vaccinations.

Screening programmes

There is no routine screening for pericarditis. If you have symptoms, see your doctor for evaluation.

Complications

If left untreated

• Pericardial effusion — fluid builds up around the heart, which may cause shortness of breath.
• Cardiac tamponade — a life-threatening condition where fluid compresses the heart and reduces blood flow out of the heart.
• Constrictive pericarditis — the pericardium becomes thickened and scarred, preventing the heart from filling properly.

Long-term outlook

With proper treatment, most people with pericarditis recover fully within a few weeks to months. Complications are rare and can be treated when caught early. Staying in touch with your doctor and following your treatment plan gives you the best chance for a good outcome.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.