Pericarditis: Understanding Inflammation Around the Heart

Written by Medicover Team and Medically Reviewed by Dr Jagadeesh Chandra Bose Y , Cardiologists

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

Pericarditis is inflammation of the thin sac, called the pericardium, that surrounds the heart. It can cause sudden chest pain that may worsen when lying down or with deep breathing. Pericarditis can develop after a viral illness, injury, heart attack, or heart surgery and may cause tiredness, shortness of breath, or chest discomfort.

Pericarditis, also known as post-cardiac injury syndrome or post-myocardial infarction syndrome in certain settings, can affect anyone. It is more common in people who have had recent infections, injuries, or heart procedures.

In some cases, pericarditis may come back more than once, which is known as recurrent pericarditis. Although it is not always serious, untreated pericarditis can lead to complications such as fluid buildup around the heart.

Along with chest pain, some people may experience a mild fever, a dry cough, or a general feeling of being unwell. Symptoms may last for a few days or weeks, depending on the cause and severity. Medical evaluation is important for confirming the diagnosis and initiating appropriate treatment.

What are the Types of Pericarditis?

Pericarditis can be classified according to how long it lasts and the underlying cause. The main types include:

Acute Pericarditis: Acute pericarditis starts suddenly and may be caused by an infection, injury, or immune system problem.
Chronic Pericarditis: This form persists for more than three months and may be associated with long-term conditions such as tuberculosis or immune-related diseases.
Recurrent Pericarditis: This occurs when symptoms improve or disappear and then return after a period without symptoms.
Constrictive Pericarditis: In this type, the pericardium becomes thick and stiff, making it harder for the heart to fill and function normally.
Uremic Pericarditis: This can occur in people with severe kidney failure when waste products build up in the blood and trigger inflammation of the pericardium.

What are the Symptoms of Pericarditis?

Pericarditis often begins with chest pain that may feel sharp or stabbing. In some cases, the pain may feel dull or like pressure. It is usually felt behind the breastbone or on the left side of the chest and may spread to the neck, shoulder, or back. The pain may become worse when lying down or breathing deeply and may improve when sitting up and leaning forward.

What are the Mild Symptoms of Pericarditis?

Sharp or stabbing chest pain
Feeling tired or weak
Mild fever
Dry cough
Shortness of breath, particularly when lying flat
Pain in the upper abdomen or under the ribs
Swelling in the legs or ankles

What are the Severe Symptoms of Pericarditis?

Severe chest pain that may resemble a heart attack
Difficulty breathing, even while sitting
Fast or irregular heartbeat or palpitations
Fainting or dizziness
Swelling in the abdomen
Chest pain that does not improve with rest

What Causes Pericarditis?

Pericarditis can develop for many reasons. It often occurs when the body responds to an infection, injury, heart condition, or other health problem. Common causes and contributing factors include:

Heart Attack or Heart Surgery: Damage to the heart can trigger an immune response that causes inflammation around the heart. This may occur as part of post-cardiac injury syndrome, also known as Dressler syndrome after a heart attack.
Viral Infections: Viruses, including COVID-19 and other viral infections, can cause pericarditis.
Injury to the Chest or Heart: Significant trauma or injury can irritate or damage the pericardium and cause inflammation.
Cancer and Radiation Therapy: Some cancers and cancer treatments, including radiation therapy involving the chest, can cause pericarditis.

Other causes may include autoimmune disorders, kidney failure, tuberculosis, and certain medicines. Identifying and treating the underlying cause can help reduce inflammation and prevent complications.

When to See a Pericarditis Doctor?

Chest pain should not be ignored because pericarditis can cause symptoms similar to a heart attack or other serious heart conditions. Seek a cardiologist's medical evaluation if you experience chest pain that lasts for more than a few hours or becomes worse when lying down or breathing deeply.

You should see a doctor if:

Chest pain persists or keeps returning
You feel short of breath, especially when lying down
You have a fast or irregular heartbeat
You notice swelling in your legs, feet, or abdomen
You feel lightheaded or faint
You have a fever with chest discomfort

Who Needs Prompt Medical Care?

People with a history of heart disease or recent heart surgery
Those with chronic kidney problems or undergoing dialysis
People who have received radiation therapy involving the chest
People with severe or rapidly worsening chest pain, breathing difficulty, or fainting

Prompt medical evaluation can help identify pericarditis and prevent complications such as significant fluid buildup around the heart, recurrent inflammation, or constrictive pericarditis.

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How Is Pericarditis Diagnosed?

To diagnose pericarditis, the doctor will ask about symptoms, medical history, recent infections, injuries, and heart procedures. A physical examination is also performed, including listening to the chest with a stethoscope. A characteristic sound called a pericardial rub may sometimes be heard when the inflamed layers of the pericardium rub against each other.

To confirm the diagnosis and determine how severe the condition is, the doctor may recommend the following tests:

What Tests Are Used to Diagnose Pericarditis?

Blood Tests: Blood tests can help detect inflammation and may also help identify other conditions, including a heart attack.
Electrocardiogram (ECG): A quick, painless test that records the heart's electrical activity using small patches placed on the skin.
Chest X-ray: This can show changes in the size or shape of the heart and may help identify an enlarged heart caused by significant fluid buildup.
Echocardiogram: This test uses sound waves to create images of the heart, assess heart function, and check for fluid around the heart.
CT Scan (Cardiac CT): This provides detailed images of the heart and chest and can help identify pericardial thickening or other abnormalities.
Cardiac MRI: Magnetic resonance imaging provides detailed images of the heart and pericardium and can help detect inflammation, thickening, and other changes.

What are the Treatment Options for Pericarditis?

Treatment for pericarditis depends on its cause, severity, and whether complications are present. Mild cases, particularly acute pericarditis, may improve with appropriate medication, rest, and treatment of the underlying cause.

What Medicines Are Used for Pericarditis?

Anti-inflammatory medicines: Medicines such as ibuprofen or aspirin may be used to reduce pain and inflammation when appropriate.
Colchicine: Colchicine can help reduce inflammation and lower the risk of recurrent pericarditis.
Corticosteroids: Corticosteroids may be considered in selected cases when other treatments are ineffective, contraindicated, or when there is a specific indication for their use.
Azathioprine or other immune-suppressing medicines: These may be considered for recurrent or refractory pericarditis that does not respond adequately to standard treatment.

People with acute pericarditis are generally advised to avoid strenuous physical activity until symptoms and inflammation have resolved and their doctor confirms that activity can be resumed.

What Procedures Are Used to Treat Pericarditis?

In some cases, fluid may build up around the heart and require drainage. Procedures may include:

Pericardiocentesis: A thin, sterile needle or tube is inserted to remove excess fluid from the pericardial space. This can relieve pressure on the heart and may be urgently required when fluid causes significant impairment of heart function.
Pericardiectomy: If the pericardium becomes severely thickened and stiff because of constrictive pericarditis, surgery may be performed to remove part or most of the pericardium and allow the heart to function more freely.

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What Is the Recovery Process After Pericarditis Treatment?

Recovery from pericarditis depends on its type, cause, and severity. Many people with acute pericarditis begin to feel better within days to weeks with appropriate treatment and rest. Regular follow-up with a heart specialist is important to monitor recovery and identify recurrent inflammation or complications.

What Does Follow-Up Care Involve?

Visit your doctor as advised, often within 1 to 2 weeks after starting treatment.
Follow-up tests such as ECG or echocardiography may be performed to monitor recovery.
If fluid has accumulated around the heart, more frequent monitoring may be required.
People with recurrent or chronic pericarditis may need longer-term follow-up and treatment adjustments.

What Precautions Can Help Prevent Pericarditis?

Pericarditis cannot always be prevented, particularly when it is caused by an underlying disease or an unavoidable medical condition. However, following medical advice, treating infections and other health conditions appropriately, and allowing adequate recovery after illness can support overall heart health.

What Are the Prevention Tips?

Eat a Healthy Diet: Choose fruits, vegetables, whole grains, and other nutritious foods while limiting excessive salt and highly processed foods.
Rest After Illness: Allow your body to recover after infections or heart-related problems and follow your doctor's advice about returning to normal activities.
Avoid Heavy Exercise During Recovery: Do not participate in strenuous workouts or sports while recovering from pericarditis unless your doctor confirms that it is safe.
Treat Underlying Conditions: Follow medical advice for infections, kidney disease, immune conditions, and other disorders that may contribute to pericarditis.
Follow Doctor's Advice: Take prescribed medicines as directed and attend recommended follow-up appointments.

What Self-Care Measures Can Help During Recovery?

Get adequate rest and sleep.
Take pain-relieving medicines only as recommended by your doctor.
Avoid unnecessary physical and emotional strain while recovering.
Ask your doctor when it is safe to return to normal daily activities and exercise.

What Are the Complications of Pericarditis?

If pericarditis is untreated or does not respond to treatment, it can sometimes lead to complications, including:

Pericardial Effusion: Excess fluid can accumulate around the heart.
Cardiac Tamponade: Severe fluid buildup can place pressure on the heart and interfere with its ability to pump blood effectively.
Constrictive Pericarditis: Long-term inflammation can cause the pericardium to become thick and stiff, restricting normal heart function.
Recurrent Pericarditis: Episodes of inflammation may return after an initial recovery.

What Are the Dos and Don'ts During Pericarditis Recovery?

Pericarditis requires appropriate medical treatment along with healthy habits and careful activity management. Following these guidelines can support recovery and help reduce the risk of complications.

Do's	Don'ts
Get enough sleep and allow your body to rest. Eat a healthy and balanced diet. Follow your doctor's recommendations about physical activity. Attend scheduled medical check-ups and follow-up tests. Take precautions to reduce the risk of infections.	Do not perform strenuous exercise while recovering unless your doctor approves it. Do not skip prescribed medications. Do not ignore new or worsening chest pain or breathing difficulty. Do not miss recommended medical follow-ups. Do not overuse painkillers without medical advice.

What Is Our Experience in Treating Pericarditis?

Pericarditis can cause chest pain, shortness of breath, and discomfort that may make everyday activities difficult. Because its symptoms can resemble those of a heart attack and other serious heart conditions, timely medical evaluation is important.

At Medicover Hospitals, our experienced heart specialists evaluate symptoms, use appropriate diagnostic tests, and develop treatment plans based on the underlying cause and severity of pericarditis. Treatment may include medicines, activity guidance, monitoring, and procedures when complications such as significant fluid buildup occur.

From diagnosis through follow-up, ongoing medical care helps monitor recovery, identify recurrence, and manage potential complications. The treatment approach is tailored to each patient's condition and recovery needs.

Frequently Asked Questions

1. Does pericarditis affect exercise or sports?

During and after recovery, it's common to limit intense exercise. Doctors often recommend gradually returning to physical activity based on healing progress and heart sac inflammation levels.

2. Can pericarditis lead to heart complications later?

Yes, some people develop pericardial effusion or constrictive pericarditis, where the heart sac tightens. This may impact heart function long term and require monitoring or intervention.

3. Is pericarditis safe during pregnancy?

Pericarditis can affect pregnant women but is managed carefully to protect both mother and baby. Monitoring heart function and inflammation is essential to ensure a healthy pregnancy.

4. How does pericarditis affect daily life?

Pericarditis may cause fatigue and limit daily tasks during recovery. Most people fully regain energy levels afterward, with support like rest, heart monitoring, and lifestyle adjustments.

5. How does Medicover support pericarditis recovery and care?

At Medicover, our cardiac care team offers personalized follow-up, heart sac monitoring and support services. We guide you through recovery with continuity and expert advice on heart health.