Inflammation is the body’s natural response to injury. Pericarditis is inflammation of the pericardium, the thin layers of tissue that surround the heart. It is often the result of an infection and can cause chest pain, rapid heartbeat and difficulty breathing.

The pericardium consists of two layers: the visceral pericardium, which is closely attached to the heart muscle, and the parietal pericardium, which is the outer layer. The space between the layers of the pericardium contains a small amount of fluid that reduces friction during heart contractions.

Several types of pericarditis exist, including acute pericarditis, constrictive pericarditis and purulent pericarditis. 

  • Acute pericarditis is the most common form. This condition is often caused by viral infections. It usually develops suddenly and can result from other medical conditions, chest trauma or cardiac surgery. Symptoms typically include chest pain which worsens with deep breaths.
  • Constrictive pericarditis, where the inflammation leads to the formation of scar tissue within the pericardium. The thickened layers of tissue restrict the heart’s ability to expand, making it difficult to function. This condition may occur after an episode of acute pericarditis or as a result of chronic inflammation.
  • Purulent pericarditis, a severe form caused by a bacterial infection that results in pus in the pericardium. This condition is rare but can be life-threatening.

In severe cases, an accumulation of excess fluid within the pericardial space known as pericardial effusion can lead to cardiac tamponade. This life-threatening type of pericarditis occurs when the fluid puts pressure on the heart muscle, affecting its ability to pump blood effectively and causing your blood pressure to drop. 

In rare instances, pericarditis can progress to constrictive pericarditis, where the pericardium becomes thickened and stiff, limiting the heart’s ability to function properly.

Risk Factors

Risk factors for pericarditis include:

  • Age
  • Sex – men are twice as likely as women to develop pericarditis
  • Genetics
  • Environment
  • Lifestyle choices
  • Medical history

Bacterial, fungal and viral infections can also lead to pericarditis. Certain autoimmune diseases, such as rheumatoid arthritis, can increase the risk of developing pericarditis.

Other pericarditis risk factors include recent heart attack or heart surgery, kidney failure and certain medications that can trigger inflammation of the pericardium.

Symptoms of Pericarditis

Symptoms of pericarditis may vary in intensity and duration depending on the underlying cause and type. Common symptoms include:

  • Chest pain
  • Fast heartbeat
  • Fever
  • Cough
  • Palpitations
  • Fatigue
  • Shortness of breath

In some cases, the symptoms may be mild. Others may experience more severe symptoms and require immediate medical attention. Pericarditis may occur as an acute episode or as a recurrent or chronic condition. 

Detection and Diagnosis

Your doctor may use imaging tests including computed tomography (CT) and magnetic resonance imaging (MRI) to diagnose pericarditis. The results of these tests alongside your medical history and a physical examination may lead to a diagnosis of pericarditis. Unfortunately, the exact cause of pericarditis can often remain unknown.

Pericarditis Treatment

Pericarditis treatment depends on the cause but can include medication to reduce pain and inflammation and antibiotics if you have an infection. Mild cases of pericarditis may go away on their own.

Acute pericarditis treatment may include anti-inflammatory medications.