Pericarditis: Causes, Symptoms, and Treatment

What Is Pericarditis?

The pericardium is a thin, double-layered membrane surrounding the heart, containing a small amount of lubricating fluid that allows the heart to beat smoothly within the chest. When the pericardium becomes inflamed, its layers rub against each other, causing pain and irritation.

Pericarditis may be acute (short-term) or chronic (long-term) and can occur by itself or alongside other heart or systemic conditions. In severe cases, inflammation can restrict the heart’s ability to expand and pump efficiently, particularly when excess fluid or scarring develops within the pericardium.

Types of Pericarditis

Pericarditis is categorised based on the duration, cause, and characteristics of inflammation:

• Acute Pericarditis: Appears suddenly and lasts less than six weeks. It’s the most common form and often follows a viral infection or respiratory illness.
• Chronic Pericarditis: Persists beyond three months or recurs intermittently over time, often requiring long-term medication.
• Constrictive Pericarditis: The pericardium becomes thick, stiff, or scarred, limiting the heart’s ability to expand and fill properly.
• Effusive Pericarditis: Involves fluid accumulation between the pericardial layers, which may interfere with normal cardiac motion.
• Purulent (Infective) Pericarditis: A rare but serious bacterial infection causing pus accumulation and intense inflammation.

Each type has distinct diagnostic and therapeutic approaches, making accurate classification important for treatment planning.

Causes of Pericarditis

Several factors can trigger pericardial inflammation, including:

• Viral infections: Such as Coxsackievirus, Echovirus, Influenza, HIV, or COVID-19.
• Bacterial or fungal infections: Less common but often severe, requiring antibiotic or antifungal therapy.
• Autoimmune disorders: Conditions like lupus, rheumatoid arthritis, or scleroderma can cause immune-mediated pericarditis.
• Post-heart attack (Dressler’s Syndrome): Occurs when the immune system reacts to damaged heart tissue.
• Kidney failure (Uremic Pericarditis): Due to toxin buildup in the bloodstream.
• Trauma or injury: Following chest injury, radiation therapy, or heart surgery.
• Certain medications: Such as hydralazine, isoniazid, and procainamide.
• Cancer: Metastatic spread from the lungs, breast, or lymphatic system.

In some cases, no identifiable cause is found — this is called idiopathic pericarditis, but it often behaves like a viral form.

Pericarditis Symptoms

Pericarditis often causes sharp, stabbing chest pain that tends to differ from the pressure-like pain of a heart attack.

Typical pericarditis symptoms include:

1. Chest pain: Sudden, intense pain that changes with posture or breathing, unlike the constant pressure of a heart attack.

2. Radiating pain: Discomfort spreading to the neck, shoulders, upper back, or arms, often mistaken for muscular strain.

3. Fever and fatigue: Mild fever, weakness, or general tiredness indicating ongoing inflammation or infection.

4. Shortness of breath: Especially when lying flat, caused by inflammation or fluid around the heart.

5. Palpitations: Sensation of fluttering or irregular heartbeat caused by irritation of the heart’s outer lining.

6. Swelling: Oedema in legs, ankles, or abdomen in severe or chronic cases with fluid buildup.

7. Persistent cough: Dry cough or chest tightness due to inflammation or fluid around the lungs and heart.

Recognising these early signs and consulting a doctor promptly can prevent further heart complications.

Also Read: Pericardial Effusion: Symptoms, Causes, and Treatments

Complications of Pericarditis

While most cases resolve without complications, untreated or recurrent inflammation can lead to serious outcomes such as:

• Pericardial Effusion: Excess fluid accumulates around the heart, increasing pressure on the cardiac chambers.
• Cardiac Tamponade: A life-threatening emergency in which accumulated fluid compresses the heart, limiting its ability to pump blood effectively.
• Constrictive Pericarditis: Chronic scarring thickens the pericardium, restricting normal heart movement.
• Chronic Recurrence: Some individuals experience repeated episodes, requiring long-term therapy and monitoring.

Early detection and intervention are key to preventing these life-threatening complications.

How is Pericarditis Diagnosed?

Diagnosis involves clinical evaluation and cardiac imaging to confirm inflammation and rule out other heart problems.

1. Electrocardiogram (ECG): Shows specific changes in heart rhythm or ST-segment elevations typical of pericarditis.
2. Echocardiogram: Uses sound waves to visualise the pericardium and detect fluid accumulation or thickening.
3. Chest X-Ray: Reveals an enlarged cardiac silhouette if effusion is present.
4. CT or MRI Scan: Provides detailed imaging of the pericardium and surrounding tissues to assess inflammation or constriction.
5. Blood Tests: Detect elevated inflammatory markers (CRP, ESR), cardiac enzymes (Troponin), or autoimmune antibodies.

Tests for Pericarditis

Doctors may recommend specialised tests to confirm the diagnosis and guide treatment:

• Echocardiogram – to check pericardial fluid and heart motion.
• Electrocardiogram (ECG) – to assess electrical activity changes.
• High-sensitivity C-reactive protein (hs-CRP) – to detect inflammation.
• Troponin I and T levels – to check heart muscle involvement.
• Erythrocyte Sedimentation Rate (ESR) – to monitor inflammation severity.
• Cardiac MRI or CT Scan – for detailed imaging of pericardial thickening.

Treatment Options

Treatment depends on the cause, severity, and duration of inflammation. The main goals are to relieve pain, reduce inflammation, and prevent recurrence.

Medications for Pericarditis

• Non-steroidal anti-inflammatory drugs (NSAIDs): Ibuprofen or aspirin help reduce pain and swelling.
• Colchicine: Used alone or with NSAIDs to shorten duration and prevent recurrence.
• Corticosteroids: For autoimmune or recurrent cases not responding to first-line therapy.
• Antibiotics or antifungal drugs: For infectious causes.
• Diuretics: To relieve swelling in effusive or constrictive pericarditis.

Procedures & Surgery

If fluid accumulation becomes significant or compresses the heart:

• Pericardiocentesis: A procedure in which a needle and catheter are used to safely drain excess fluid from the pericardium.
• Pericardiectomy: Surgical removal of part or all of the pericardium, performed in chronic constrictive pericarditis to restore normal heart function as per the National Institutes of Health (NIH).

Lifestyle & Home Care Tips

Long-term recovery from pericarditis also depends on healthy habits:

• Rest adequately during recovery to reduce cardiac strain.
• Avoid intense physical activity until your doctor clears you.
• Follow a heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins.
• Stay hydrated and avoid excessive alcohol or caffeine.
• Manage chronic illnesses like diabetes or hypertension effectively.
• Follow medication schedules strictly and attend regular follow-ups.

Recovery & Prognosis

Most pericarditis cases resolve within a few weeks with prompt medical care, appropriate medication, and adequate rest.

Recovery time varies depending on cause, severity, and treatment response, but early diagnosis ensures better outcomes and fewer complications.

Recurrent or chronic cases may require long-term anti-inflammatory therapy and periodic monitoring through ECG and echocardiography.

With proper care, lifestyle changes, and follow-up, most patients regain full cardiac function and lead normal, active lives.

Preventive Measures

1. Manage underlying conditions: Control diabetes, hypertension, or autoimmune diseases through regular check-ups to reduce the risk of pericardial inflammation.

2. Treat infections promptly: Seek timely care for respiratory or viral infections like flu or COVID-19 to prevent inflammation from spreading to the heart.

3. Avoid self-medication: Do not take painkillers or antibiotics without a prescription; some drugs may trigger pericarditis or worsen heart inflammation.

4. Monitor heart health post-surgery: After a heart attack or cardiac procedure, schedule ECGs or echocardiograms to detect early inflammation.

5. Boost immunity: Eat a balanced diet, stay hydrated, exercise regularly, and get sufficient rest to strengthen immunity and heart health.

6. Manage stress: Reduce emotional and physical stress through yoga, meditation, or relaxation exercises to maintain healthy heart function.

7. Avoid toxins and smoking: Quit smoking and limit alcohol to prevent oxidative stress and reduce the risk of heart inflammation.

8. Regular heart check-ups: Schedule periodic cardiac tests, such as ECG, CRP, or Troponin, to monitor heart health and detect early signs of pericarditis.

Conclusion

Pericarditis is usually manageable when detected early and treated appropriately. Recognising early warning signs such as chest pain, shortness of breath, or fatigue is vital. Regular cardiac check-ups, imaging tests, and inflammation markers help ensure accurate diagnosis and timely intervention.

Metropolis Healthcare offers a comprehensive range of heart-related tests — including Echocardiogram, ECG, hs-CRP, ESR, and Troponin levels — along with convenient home sample collection, 4000+ diagnostic tests, and fast, accurate results across 10,000+ touchpoints.

Early diagnosis, proper treatment, and consistent monitoring can help preserve heart function and support a full, active life.

Must Read: Heart Disease: Symptoms, Causes, Types And Treatment

FAQs About Pericarditis

What causes pericarditis?

Pericarditis may result from viral infections, autoimmune diseases, trauma, or post-surgical inflammation. In many cases, the exact cause remains unknown but is often linked to a recent infection.

Can you fully recover from pericarditis?

• Yes, most people recover completely with anti-inflammatory medication and rest.
• Prevent recurrence by completing prescribed treatments and following up regularly.

Can pericarditis be fatal?

Severe complications like cardiac tamponade can be life-threatening if untreated. However, with early diagnosis and care, fatalities are extremely rare.

How long does pericarditis last?

Acute cases resolve in 2–4 weeks, while chronic pericarditis may persist or recur for months.

Is pericarditis contagious?

No. Even when caused by a virus, the inflammation itself is not contagious.

How is pericarditis treated at home?

• Take prescribed medications as directed.
• Avoid strenuous activity.
• Eat a balanced diet and stay hydrated.
• Monitor chest pain and seek immediate care if symptoms worsen.

References

https://pmc.ncbi.nlm.nih.gov/articles/PMC10860389/

https://www.ncbi.nlm.nih.gov/books/NBK431080/

https://www.heart.org/en/health-topics/pericarditis/what-is-pericarditis

https://medlineplus.gov/ency/article/000182.htm