Acute Pericarditis: Symptoms and Treatment

Written by Medicover Team and Medically Reviewed by Dr Pabba Anish , Cardiologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Acute pericarditis is an inflammatory condition affecting the pericardium, the two-layered sac that surrounds and protects the heart. It often develops suddenly and may cause chest pain and other symptoms that require medical attention.

The pericardium has two layers: the visceral pericardium (inner layer attached to the heart) and the parietal pericardium (outer fibrous layer). A small amount of lubricating fluid between these layers allows the heart to move smoothly within the chest. When inflammation occurs, the fluid may increase, leading to pericardial effusion, which can complicate the condition.

What Are the Types of Acute Pericarditis?

Pericarditis can be categorised based on how long the symptoms last and how the disease progresses.

The main types include:

Acute pericarditis: starts suddenly and usually lasts up to 4 weeks
Recurrent pericarditis: occurs again 4 to 6 weeks after the initial episode, with symptom-free periods in between
Incessant pericarditis: lasts between 4 weeks and 3 months with ongoing symptoms
Chronic constrictive pericarditis: develops slowly and lasts longer than 3 months, often causing thickening of the pericardium

What Are the symptoms of Acute Pericarditis?

Symptoms usually appear suddenly and may vary in severity depending on the underlying cause and the level of inflammation. The most common symptom is chest pain.

Common symptoms include:

Sharp or stabbing chest pain behind the breastbone or on the left side of the chest
Pain that spreads to the left shoulder, neck, or both shoulders
Pain that worsens when coughing, lying down, or taking deep breaths
Pain that improves when sitting up or leaning forward
Shortness of breath, especially when lying down
Fatigue or general weakness
Low-grade fever
Cough
Palpitations (pounding or racing heartbeat)
Swelling in the legs or feet
Abdominal swelling

What Causes Acute Pericarditis?

Acute pericarditis can develop due to several infectious or non-infectious factors. In many cases, the exact cause may remain unknown.

Common causes include:

Infections such as viral infections, tuberculosis, HIV, or rarely fungal and parasitic infections
Cancer affecting the pericardium or tumors spreading from other parts of the body
Autoimmune diseases such as lupus, rheumatoid arthritis, or Sjogren's syndrome
Hormonal disorders, including hypothyroidism or ovarian hyperstimulation syndrome
Chest trauma caused by blunt injuries or penetrating wounds
Heart-related conditions such as a heart attack or aortic dissection

When should you see a Doctor for Acute Pericarditis?

Medical attention is important if symptoms such as chest pain or breathing difficulty appear, as they may be signs of other serious heart conditions.

You should consult a doctor if you experience:

Persistent or severe chest pain
Shortness of breath or difficulty breathing
Fever along with chest discomfort
Swelling in the legs or abdomen
Rapid or irregular heartbeat

This condition is usually evaluated and treated by specialists such as:

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How is Acute Pericarditis Diagnosed?

Doctors diagnose acute pericarditis by reviewing symptoms, performing a physical examination, and recommending diagnostic tests to confirm inflammation of the pericardium.

Common diagnostic methods include:

Electrocardiogram (ECG) to detect characteristic electrical changes in the heart
Blood tests to identify elevated inflammatory markers such as CRP and ESR
Cardiac biomarkers like troponin to assess heart muscle involvement
Echocardiography to detect pericardial effusion and evaluate heart function
Chest X-ray to identify enlargement of the heart if significant fluid accumulation is present

What Are the Treatment Options for Acute Pericarditis?

Treatment focuses on reducing inflammation, relieving symptoms, and preventing complications. The treatment plan may vary depending on the underlying cause and severity.

Common treatment options include:

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin to reduce pain and inflammation
Colchicine to lower the risk of recurrence
Corticosteroids in cases where NSAIDs are ineffective or unsuitable
Antibiotics if the condition is caused by a bacterial infection
Adequate rest until symptoms improve
Regular medical monitoring to track recovery and detect complications early

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What is the Recovery Process for Acute Pericarditis?

Recovery varies depending on the severity of inflammation and the treatment used. Many patients recover fully with proper treatment and monitoring.

The recovery process generally includes:

Taking prescribed medications regularly
Getting sufficient rest to allow the heart to heal
Attending follow-up appointments for monitoring
Avoiding strenuous physical activity until advised by the doctor
Managing underlying health conditions that may trigger recurrence

Frequently Asked Questions

1. What are the symptoms of acute pericarditis?

Symptoms include chest pain, shortness of breath, and fatigue.

2. What causes acute pericarditis?

It can be caused by viral infections, heart attack, or autoimmune diseases.

3. How is acute pericarditis treated?

Treatment involves anti-inflammatory medications, pain relief, and in severe cases, surgery.

4. How is acute pericarditis diagnosed?

Diagnosis is made through an echocardiogram, ECG, and blood tests.

5. What are the complications of acute pericarditis?

Complications can include pericardial effusion or chronic pericarditis.

6. What are the 4 criteria for acute pericarditis?

The 4 criteria for acute pericarditis include: chest pain, pericardial friction rub, characteristic ECG changes, and evidence of pericardial effusion or inflammation.

7. Does pericarditis show on ECG?

Yes, acute pericarditis shows characteristic ECG changes, including ST-segment elevation, PR-segment depression, T-wave inversion, and later T-wave normalization.