Pericarditis is an inflammation of the pericardium, a thin, two-layered sac that surrounds the heart and holds it in place within the chest. The pericardium also produces a small amount of fluid that lubricates the heart, reducing friction with surrounding tissues during heartbeats. When the pericardium becomes inflamed, it can lead to discomfort, pain, and other symptoms.

Overview

Pericarditis can be acute or chronic, depending on the duration of the inflammation. Acute Pericarditis occurs suddenly and typically lasts for a short period, while chronic Pericarditis persists over a more extended period, often for several months. The condition can affect individuals of any age but is more commonly seen in men aged 20 to 50 years.

Pericarditis can be categorized based on the underlying cause. Viral infections are the most common cause of acute Pericarditis, while autoimmune conditions often cause chronic Pericarditis.

Symptoms of Pericarditis

Pericarditis symptoms can be variable and can mimic other health conditions. The hallmark symptom is chest pain, which can have unique characteristics:

• Localized Pain: Pain from Pericarditis is usually centered in the middle or left side of the chest.
• Intensity and Quality of Pain: The pain may range from sharp and stabbing to dull and pressure-like.
• Pain Pattern: Unlike angina or a heart attack, the chest pain of Pericarditis usually worsens with deep breathing, coughing, swallowing, or lying down. It often gets better when sitting up or leaning forward.
• Radiation: The pain may radiate to the neck, left shoulder, or back.
• Duration: It may last several hours and may even persist for days.

Besides chest pain, other symptoms of Pericarditis may include:

• Shortness of Breath: This can be particularly pronounced when lying down and may improve when sitting up.
• Fatigue or Weakness: As with any inflammatory condition, Pericarditis can make you feel generally unwell and tired.
• Low-grade Fever: Inflammation often produces a mild fever.
• Heart Palpitations: Some individuals may experience abnormal heart rhythms.
• Swelling: Fluid retention can lead to swelling in the legs or abdomen.
• Dry Cough: Fluid around the heart may irritate nearby structures, leading to a persistent dry cough.

Causes

Pericarditis can result from various causes, including:

1. Viral Infections: Most cases of acute Pericarditis are due to viral infections, such as those caused by Coxsackievirus, Echovirus, or the virus that causes COVID-19.
2. Autoimmune Disorders: Conditions like lupus, rheumatoid arthritis, or scleroderma can cause chronic Pericarditis.
3. Heart Surgery or Trauma: Injury to the heart or pericardium can lead to inflammation.
4. Cancer: Tumors near the heart or metastatic cancer can cause Pericarditis.
5. Kidney Failure: Uremia (buildup of waste products in the blood) can lead to inflammation.
6. Certain Medications: Some drugs, like hydralazine or isoniazid, can cause Pericarditis.
7. Other Conditions: Tuberculosis, radiation therapy, or bacterial infections can also cause Pericarditis.

Risk Factors for Pericarditis

While Pericarditis can affect anyone, some factors may increase the risk of developing the condition:

1. Age and Gender: Pericarditis is more common in men, and it often affects those between 20 and 50 years old.
2. Viral Infections: A significant number of Pericarditis cases are triggered by viral infections, such as those caused by Coxsackievirus, Echovirus, or the virus that causes COVID-19.
3. Autoimmune Disorders: Conditions like systemic lupus erythematosus (SLE), rheumatoid arthritis, or scleroderma can increase the risk of developing Pericarditis.
4. Heart Surgery: Having had recent open-heart surgery, like coronary artery bypass grafting (CABG), can be a risk factor for Pericarditis.
5. Trauma: Trauma to the chest or heart, whether from an accident or a penetrating injury, can increase the risk.
6. Other Health Conditions: Kidney failure, tuberculosis, and certain cancers (especially lung or breast cancer) can also increase the risk of developing Pericarditis.
7. Certain Medications: Some drugs, such as hydralazine (used to treat high blood pressure) or isoniazid (used to treat tuberculosis), can increase the risk of developing Pericarditis.
8. Radiation Therapy: People who have had radiation therapy to the chest for cancer treatment are at an increased risk.

How to Avoid It

To reduce the risk of developing Pericarditis:

• Prevent Infections: Practice good hygiene, get vaccinated, and avoid contact with sick individuals.
• Manage Chronic Conditions: Monitor and manage autoimmune disorders, kidney failure, and other chronic conditions.
• Follow Medication Guidelines: Use medications as prescribed and discuss potential side effects with your healthcare provider.

When to See the Doctor

Seek medical attention if you experience symptoms of Pericarditis, such as chest pain or shortness of breath. It is essential to get a proper diagnosis and begin treatment promptly to prevent complications.

Treatment

Treatment for Pericarditis depends on the underlying cause:

• Medications: Anti-inflammatory drugs, such as ibuprofen, or colchicine may be prescribed to reduce inflammation.
• Pericardiocentesis: If there is a large amount of fluid, a procedure to remove it may be necessary.
• Treat Underlying Causes: Addressing infections, autoimmune conditions, or other causes is essential.
• Surgery: In rare cases, a pericardiectomy (removal of the pericardium) may be necessary.

Pericarditis is an inflammation of the heart’s protective sac that can result from various causes, including infections, autoimmune disorders, and heart surgery. Understanding the symptoms, risk factors, and treatment options is crucial for managing this condition and maintaining heart health.