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The heart is covered with a two-layered thin membrane or fluid-filled sac called the pericardium. The pericardium is very important to prevent excessive movement of the heart when the body moves or changes position. It also keeps the infections and tumors at bay as well as preventing heart enlargement.

What is Pericarditits?

The inflammation of the pericardium is called as pericarditis. The inner and outer layers containing the lubricating fluid become sticky and cause fluid accumulation. This fluid presses against the heart and affects its pumping action.

Symptoms of Pericarditis

Acute pericarditis is the condition where the symptoms occur for less than 6 weeks, subacute is considered 6 weeks to 6 months and chronic is more than 6 months of symptoms.

These symptoms include:

  • Sharp, stabbing pain behind the breast bone or left side of the chest in case of acute pericarditis.
  • Pain worsens when one coughs, takes in a deep breath, lies down or swallows food
  • Shortness of breath
  • Low-grade fever
  • Dry cough
  • Swelling on the abdomen or leg
  • Weakness, fatigue
  • Pain lasts for hours or days

In many cases, the symptoms of pericarditis are similar to myocardial infraction.

What Causes Pericarditis?

Pericarditis can occur due to many reasons. In many cases, the cause is found to be idiopathic in nature. This means the cause is usually unknown.

In majority of the cases, a bacterial or viral infection is the cause for inflammation of the pericardium.Bacterial includes pneumococcus or tuberculous pericarditis. Coxsackievirus, cytomegalovirus, herpesvirus and HIV are some of the viral causes. Fungal pericarditis can occur due to infection of histoplasmosis, Coccidiodes, Aspergillus, Candidia. It can also develop when the heart muscles are damaged after a heart attack or heart surgery.

Other reasons include systemic inflammatory diseases like rheumatoid arthritis or lupus. In a few cases, people with kidney failure, tuberculosis, cancer or AIDS can lead to pericarditis. Trauma to the heart due to a major accident or chest trauma can lead to swelling.

Diagnosis of Pericarditis

The doctor will check the symptoms of sharp pain in chest and back of the shoulders is sign of pericarditis or a heart attack. He will check the heart sounds with a stethoscope. A rubbing or creaking sound, called the ‘pericardial rub’ will be heard. This sound is the rubbing of the two membranes of the pericardium. Other diagnostic tests include:

  • Chest X-ray
  • Electrocardiogram
  • Echocardiogram
  • Cardiac catheterization
  • Blood tests ESR, C reactive protein levels, etc.

Treatment for Pericarditis

The treatment depends on the cause of pericarditis. Viral pericarditis is treated with the help of aspirin or NSAIDs. Other treatments include:

  • Antibiotics for bacterial infection
  • Pericardiocentesis for pericardial effusion
  • Use of colchicine drug that helps reduce inflammation
  • Pericardiectomy in case of constrictive pericarditis

Recovery of mild to moderate cases of pericarditis takes a few weeks. Severe froms take months to recover. Any unusal pain in the chest, that spreads to the back and shoulder should be bought to the notice of the doctor. Pericarditis is treatable with prompt medical care.

Written by: Saptakee sengupta
Date last updated: March 29, 2015