Pericarditis

When to call emergency services

Some symptoms that feel like signs of pericarditis could quickly become dangerous health issues. You should call emergency services immediately if you experience chest pain that:

• Spreads to your arms, neck, back, or jaw
• Makes your chest feel tight and heavy
• Comes with shortness of breath, sweating, and nausea
• Lasts more than 15 minutes

What is pericarditis?

Pericarditis refers to the inflammation of the protective fluid-filled sac around the heart, known as the pericardium. This condition can cause sharp chest pain when the irritated layers of the heart's lining rub against each other. 

Although not normally serious, it can be alarming and potentially lead to complications. 

It can be difficult to confirm the exact cause of pericarditis, but it usually occurs following a viral infection, such as a cold or flu. Inflammation of areas such as the pericardium is one of your body's instinctive reactions to fight off such infections.

Pericarditis is usually mild and goes away without treatment. Anyone can suffer from pericarditis, even those who are active and in good health. Seeking early diagnosis can help reduce the risk of long-term health issues and you’ll be in the best hands if you seek a swift diagnosis with HCA UK.

Pericarditis vs myocarditis

Pericarditis and myocarditis are both conditions that involve heart inflammation. Pericarditis affects the pericardium, whereas myocarditis affects the heart muscle. 

Both conditions are commonly caused by viral infections and some people may experience both at the same time. This is known as myopericarditis.

Types of pericarditis 

You'll typically experience different symptoms depending on the type of pericarditis you have. It's important to receive the correct diagnosis for pericarditis so a cardiologist can understand the severity of the condition and provide the most effective treatment. The condition is grouped into these categories:

• Acute pericarditis: This can start suddenly but doesn't usually last longer than three weeks. It can be difficult to recognise the difference between acute pericarditis and pain caused by a heart attack.
• Recurrent pericarditis: This occurs about four to six weeks following an episode of acute pericarditis. You shouldn't experience any symptoms in between.
• Incessant pericarditis: Symptoms of this type of pericarditis are usually continuous. It will last about four to six weeks and no longer than three months.
• Chronic pericarditis: This develops gradually and lasts longer than three months. 

What causes pericarditis?

While pericarditis signs usually arise following an infection, such as cold, flu, or COVID-19, the condition could also be a direct cause of:

• An immune system response after your heart is damaged, usually from surgery or a heart attack
• Inflammatory disorders, including lupus and rheumatoid arthritis
• Injury to the heart or chest
• Chronic health conditions, including kidney failure and cancer

Not understanding the cause of cardiac conditions can be frustrating and difficult to live with. That's why it's so important to make an appointment as soon as possible to determine the reasons for your pericarditis pain. 

Potential complications of Pericarditis

Early diagnosis and treatment for pericarditis can significantly reduce the risk of further health complications. However, you may be exposed to the following risks as a result of the condition: 

• Pericardial effusion: Refers to the buildup of fluid around the heart.
• Cardiac tamponade: A condition that puts pressure on the heart due to the buildup of fluids. It prevents the heart from filling properly and less blood gets pumped around the body as a result. This can cause a dramatic drop in blood pressure which may require emergency treatment.
• Constrictive pericarditis: Involves the thickening and scarring of the heart lining, which can stop it from functioning properly.

What are the pericarditis diagnosis criteria?

A diagnosis of pericarditis will require a specialist to listen to your heart as the condition can change its overall sound. To confirm pericarditis, a cardiologist may: 

• Perform a physical assessment
• Review your medical history
• Arrange an echocardiogram to detect the presence of fluid or an electrocardiogram (ECG) to detect changes to your heart rhythm
• Arrange a chest X-ray
• Check for inflammation with blood tests

These tests are common and usually last a few minutes. Most people don't feel any pain or discomfort during them. If you visit any of our diagnostic centres, you'll receive your test results within 48 hours. 

If you've received a diagnosis of pericarditis chest pain, your consultant will discuss your results in further detail. You'll also be advised of any pericarditis treatments you may require.

How to treat pericarditis

There are several types of treatment for pericarditis, depending on the cause and severity of your condition. You'll typically be prescribed anti-inflammatory painkillers, such as ibuprofen, for one or two weeks to help ease the pain symptoms. However, if the condition persists, you may be given stronger medication or require surgery.

Pericarditis medication

• Colchicine: This is a type of medicine used for treating pain and inflammation. It will be prescribed if anti-inflammatory painkillers don't work and the condition keeps coming back.
• Corticosteroids: These are strong medications that fight inflammation. Corticosteroids may be prescribed if Colchicine hasn't worked or pericarditis symptoms persist.
• Antibiotics: If your condition was caused by a bacterial infection, you could be prescribed antibiotics as per pericarditis treatment guidelines.

Pericarditis surgery

If symptoms continue to worsen or your condition has caused fluid buildup around the heart, you may need to undergo surgery or other procedures to drain this fluid. These include:

• Pericardiocentesis: A sterile needle or small tube (catheter) is used to drain excess fluid from the pericardial cavity.
• Pericardiectomy: The pericardium may need to be removed partially or completely if it is in a permanently rigid state caused by constrictive pericarditis.

Can you prevent pericarditis?

There are no specific prevention methods for pericarditis. However, there are some simple steps to avoid the likelihood of getting an infection and reduce the risk of heart inflammation. These include:

• Avoiding close contact with people who have viral/flu-like illnesses
• Practising good hygiene like regular hand washing to prevent the spread of viruses
• Staying up-to-date with all recommended vaccines