The heart is surrounded by a double-layered membrane called the pericardium. A few millilitres of liquid separate the two layers and allow the heart to move with each cardiac contraction.
Pericarditis is the inflammation of the pericardium. When pericarditis occurs, the liquid between the two layers of the pericardium may increase, which is called pericardial effusion. The accumulated liquid may eventually compress the heart and interfere with its normal function.
Very often the cause of pericarditis is unknown. Pericarditis is referred to as idiopathic in this case, although it may result from an infection of a virus of the same type that causes a cold.
Pericarditis can also occur following:
- An infarct
- Heart surgery
- A bacterial or other type of infection
- Radiotherapy treatment
- Invasion from a nearby cancerous tumour
- Chest trauma
The most frequent symptoms of pericarditis are:
- Chest pain that may radiate to the neck, shoulder and back. The pain is often intense when the person breathes deeply or coughs or when the person is lying down. The pain may be partially relieved when the person leans forward.
- Fever (oral temperature > 38 °C), fatigue, chills, joint pain, excessive sweating and headaches. All of these symptoms may indicate a viral infection.
More rarely, the following symptoms may occur:
- Shortness of breath
- Palpitations
- Swelling in the legs or abdomen
After filling out a comprehensive questionnaire and performing a physical exam, the doctor will prescribe some of the following tests to confirm the diagnosis, establish the severity of the problem and determine the best treatment if he or she suspects pericarditis.
In the case of idiopathic or viral pericarditis, the treatment basically consists of decreasing the inflammation and the amount of accumulated liquid through a variety of anti-inflammatory drugs.
Treating a specific cause of pericarditis is also essential and will depend on the diagnosed illness.
Pericardial puncture, a procedure that consists of inserting a thin needle through the rib cage to the pericardial sac, is sometimes necessary either to decrease the amount of liquid and improve heart function or to determine a more accurate diagnosis through an analysis of the fluid removed (e.g., infection, cancer).