Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.
The cause of pericarditis is unknown or unproven in many cases. It mostly affects men ages 20 to 50 years.
Pericarditis is often the result of an infection such as:
The condition may be seen with diseases such as:
Other causes include:
Chest pain is almost always present. The pain:
You may have fever, chills, or sweating if the condition is caused by an infection.
Other symptoms may include:
When listening to the heart with a stethoscope, the health care provider can hear a sound called a pericardial rub. The heart sounds may be muffled or distant. There may be other signs of excess fluid in the pericardium (pericardial effusion).
If the disorder is severe, there may be:
The following imaging tests may be done to check the heart and the tissue layer around it (pericardium):
To look for heart muscle damage, the provider may order a troponin I test. Other laboratory tests may include:
The cause of pericarditis should be identified, if possible.
High doses of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are often given with a medicine called colchicine. These medicines will decrease your pain and reduce the swelling or inflammation in the sac around your heart. You will be asked to take them for days to weeks or longer in some cases.
If the cause of pericarditis is an infection:
Other medicines that may be used are:
If the buildup of fluid makes the heart function poorly, treatment may include:
Surgery called pericardiectomy may be needed if the pericarditis is long-lasting, comes back after treatment, or causes scarring or tightening of the tissue around the heart. The operation involves cutting or removing part of the pericardium.
Pericarditis can range from mild illness that gets better on its own, to a life-threatening condition. Fluid buildup around the heart and poor heart function can complicate the disorder.
The outcome is good if pericarditis is treated right away. Most people recover in 2 weeks to 3 months. However, pericarditis may come back. This is called recurrent, or chronic, if symptoms or episodes continue.
Scarring and thickening of the sac-like covering and the heart muscle may occur when the problem is severe. This is called constrictive pericarditis. It can cause long-term problems similar to those of heart failure.
Contact your provider if you have symptoms of pericarditis. This disorder is not life threatening most of the time. However, it can be very dangerous if not treated.
Many cases cannot be prevented.
Chabrando JG, Bonaventura A, Vecchie A, et al. Management of acute and recurrent pericarditis: JACC State-of-the-art Review. J Am Coll Cardiol. 2020;75(1):76-92. PMID: 31918837 pubmed.ncbi.nlm.nih.gov/31918837/.
Knowlton KU, Savoia MC, Oxman MN. Myocarditis and pericarditis. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 80.
Lewinter MM, Cremer PC, Klein AL. Pericardial Diseases. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 86.
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.