Pericarditis

What is the pericardium?

The pericardium is a fluid-filled sac which protects the heart and helps your heart stay in position in your chest. This helps your heart to function as it should.

What is pericarditis?

Pericarditis is inflammation of the pericardium. This can sometimes lead to fluid building up between the 2 layers of the pericardium, causing symptoms.

What are the symptoms of pericarditis?

• A sharp chest pain – which is worse when you take a deep breath, lie down or cough

• Pain in the neck or stomach if the chest pain spreads

• Fever 

• Breathing quicker

• Feeling short of breath – if you suddenly feel short of breath, seek medical advice as soon as possible. 

As pericarditis presents with sudden chest pain, you should seek medical advice as soon as possible by calling 111.

If the chest pain is predominantly on the left side, spreads down into your arm and neck, and you feel sweaty and nauseous, call 999 as these symptoms are more like a heart attack.

What causes pericarditis?

• Viral illnesses, such as Covid-19, are a common cause of pericarditis. Though not all Covid infections lead to pericarditis, with 1.5% people developing pericarditis after having Covid. 

• Having previously had a heart attack 

• Having an existing autoimmune condition – it’s possible that your immune system can attack healthy organs like the heart

• Radiotherapy to the chest region 

• Kidney failure 

• Recent trauma to the chest region

How is pericarditis diagnosed?

• A doctor will listen to your chest and heart

• You may have an ECG, which is an electrical tracing of the heart, and this will show typical changes and rule out things like a heart attack

• You may have blood tests to show inflammatory changes

• You may have a chest x-ray which can show if there’s any fluid around your heart 

In some cases you may be referred for an echocardiogram which uses sound waves to look at the heart.

How is pericarditis managed?

Pericarditis is usually treated with anti-inflammatory medications to lower your fever and help relieve chest pain. 

If you have symptoms which don’t resolve or keep coming back, you might be given colchicine, which is a medication that you’d use for a longer period.

The underlying cause of the pericarditis can also be treated more specifically.

What are complications of pericarditis?

Sometimes, fluid can build up to such an extent around your heart that it can increase pressure in the pericardium. As this is a sac that surrounds the heart, it has a fixed volume of space. If the pressure in this space increases too much, it can press on the heart, which can affect how effectively the heart can pump. This is called constrictive pericarditis and can be dangerous.

If this happens, you’ll become breathless and will need to go to hospital urgently. The healthcare professionals will drain the fluid out from your chest to improve your symptoms.

When should I seek help?

If you experience sudden onset chest pain, call either 111 or 999 immediately, depending on the pattern of your symptoms.