Pericarditis: Thin layers surround your heart. They are sac-like tissue or membranes that hold the heart in place and help it work. These sac-like membranes are separated by some fluid which offers no friction between them. Pericardium acts like a shock absorber and thus protects the heart from mechanical injury. Pericarditis refers to inflammation (irritation and swelling) of the pericardium. The two sac-like membranes of the pericardium rub against each other due to irritation, swelling and inflammation and cause sharp chest pain. In addition to chest pain, pericarditis is associated with other symptoms as well.

What are the causes of pericarditis?

In the majority of the cases, the cause of pericarditis is idiopathic or unknown. In some cases, the cause can be due to infections – viral, bacterial or fungal infections. The other possible causes of pericarditis may include heart injuries, medications, other medical conditions, heart surgery and heart attack.

Heart attack can also lead to pericarditis because pericarditis can develop shortly after a major heart attack due to inflammation of the damaged heart muscle. Heart surgery or post-heart attack may also cause a delayed form of pericarditis.

The delayed pericarditis that may occur weeks after a heart attack is known as post-cardiac injury syndrome, post-myocardial infarction syndrome, post-pericardiotomy syndrome or Dressler’s syndrome.

What are the other causes of pericarditis?

  • Heart injury: Trauma or injury to the chest and heart due to accident
  • Medications: Certain medicines can cause pericarditis
  • Other conditions: Cancer, tuberculosis, AIDS and kidney failure may also cause pericarditis.
  • Rheumatoid arthritis and lupus and other systemic inflammatory disorders can also cause pericarditis.

Chest pain is a common symptom of pericarditis. When the two sac-like membranes rub each other due to irritation and inflammation, you may experience chest pain just like a heart attack pain.

Classification of pericarditis according to the duration and pattern of the symptoms associated with it.

Acute pericarditis: This type of pericarditis develops suddenly and may continue up to several months. Pericardium gets inflamed (swollen and red). Fluid accumulates between pericardial layers (pericardial effusion). The condition subsides mostly after two to three months, but episodes can be intermittent for years.

Symptoms of Acute pericarditis: The symptoms associated with acute pericarditis may usually last for up to three weeks.

  • Stabbing and sharp chest pain behind the breastbone – the most common symptom
  • Sharp pain in the left side of your chest
  • Sometimes dull, achy and pressure like pain in the chest
  • Chest pain of varying intensity

Chronic Pericarditis –The symptoms associated with chronic pericarditis may last for more than three months.

Symptoms of Chronic Pericarditis: The most common and prominent symptom of chronic pericarditis is chest pain. Chronic inflammation associated with this condition may lead to an accumulation of fluid around the heart (pericardial effusion)

Common Symptoms of pericarditis

 Some of the common symptoms of pericarditis include the following:

  • Heart palpitations
  • Intense chest pain
  • Chest pain that becomes intense with breathing in
  • Trouble breathing when you lie
  • Intense and sharp chest pain in the centre (breastbone) or left side of the chest
  • Shortness of breath when reclining
  • Abdominal swelling or leg swelling
  • Cough
  • Low-grade fever
  • Feeling sick or malaise
  • Weakness or fatigue
  • Pain in your back, neck or left shoulder down
  • Anxiety

What makes pericarditis worse?

Pain due to pericarditis may get worse when you: Take deep breaths, swallow, cough or lie flat.

Pericarditis pain may get better when you lean forward or sit up.

You also may feel the need to bend over or hold your chest to breathe more comfortably.

When to see a doctor

Many patients tend to end up late assuming their symptoms to be quite normal. They also think that their symptoms may be due to any other health issues. Many times, the symptoms of pericarditis mimic other lung and heart problems. Sometimes, the real cause of acute chest pain may be pericarditis, but it could also be due to blood clot, heart disease or heart attack or clot in the lungs (pulmonary embolus).

The reason for being late in consulting a cardiologist could be their lenient approach. However, the sooner you go and consult a specialist doctor the better. The reason – there is a huge possibility of complete evaluation by a cardiologist and early diagnosis of pericarditis. Once pericarditis is diagnosed early, you will receive the best treatment.

Therefore, you must seek immediate medical care if you develop any new symptoms of pericarditis related to your chest pain. Early diagnosis and treatment play an important role in reducing your risk of complications in the long-run.

If you have intense, squeezing chest pain, call emergency care services because you may be having a heart attack.