Pericarditis is when the thin protective layer around your heart, called the pericardium, gets inflamed. This condition can make your chest hurt and make it hard to breathe. About 5% of folks with sudden chest pain are dealing with pericarditis. Most of the time, it happens after some kind of infection. Taking over-the-counter painkillers and getting plenty of rest usually help, but some people might need prescriptions or, in rare cases, surgery to feel better.
Pericarditis can be categorized by its cause. If there’s no known cause, it’s called idiopathic pericarditis. Other types have different causes, and it’s also classified by how long the symptoms last. Here are four common categories: acute, chronic, incessant, and recurrent. Recurrent pericarditis makes up about 30% of cases.
The symptoms of pericarditis include chest pain, which is the most frequent one. This pain can sometimes feel like a heart attack, but there are differences. Heart attack pain is due to reduced blood flow, while pericarditis pain is from nerve irritation and inflammation. Pericarditis pain often gets worse when lying down and improves when sitting up and leaning forward, unlike heart attack pain, which doesn’t change with position or rest.
Most pericarditis cases are idiopathic, but viral infections like a chest cold or pneumonia can lead to it too. In regions like sub-Saharan Africa, tuberculosis is a common culprit. Some health conditions, such as viral infections of the respiratory or digestive system, are also linked to pericarditis. People between 16 and 65 years old and assigned male at birth are at higher risk, along with those taking certain medications.
A cardiologist usually diagnoses and treats pericarditis. To identify acute pericarditis, two out of four specific symptoms need to be present. A cardiologist might first rule out other conditions that share similar symptoms. For treatment, anti-inflammatory medicines are commonly given, alongside recommendations to rest, especially if you have a fever. In certain cases, antibiotics are necessary if a bacterial infection is the cause.
While most pericarditis episodes clear up in a few weeks, more severe, ongoing symptoms might require surgery, such as a pericardiectomy, to remove the pericardium. Unknown causes make prevention tricky, but discussing the risks of medications like Epanutin and Coumadin with your healthcare provider is essential. To prevent recurrence, you might consider taking regular anti-inflammatory meds like NSAIDs.
Common conditions that can occur alongside pericarditis include high blood pressure, chronic kidney disease, and diabetes, which may contribute to heart inflammation. Other diseases involving the immune system might also lead to pericarditis due to inflammation or an immune response.
Rarely, pericarditis can lead to complications like cardiac tamponade, where fluid pressure builds around the heart, or constrictive pericarditis, where the protective tissue scars. These conditions can seriously impact heart function and be life-threatening. While acute pericarditis often resolves on its own with NSAIDs and rest, about half of those who need steroid treatments might experience a recurrence.
If pericarditis returns, your doctor might prescribe extra medication to relieve symptoms. It can take months to recover from recurrent pericarditis, but sticking to your treatment plan will help speed up the recovery.
