Conditions

Pericarditis

Pericarditis — Dr Agueznai, Cardiologist in Casablanca

Pericarditis is an inflammation of the pericardium, which leads to non-specific symptoms such as fever, muscle and chest pain, breathing difficulties and palpitations (acute pericarditis), or increased fatigue, breathlessness, cough, oedema and fluid build-up in the abdomen (chronic pericarditis). The pericardium is the protective membrane, made up of two layers – and a lubricating fluid – that surrounds the heart. When it becomes inflamed, the layers can no longer slide over each other without friction, and their contact causes pain and discomfort. There are different types of pericarditis, which may be acute or chronic (lasting more than 6 months): a distinction is made in particular between acute pericarditis, constrictive pericarditis (chronic thickening of the pericardium) and effusive pericarditis (chronic build-up of fluid between the two layers of the protective membrane).

What causes acute or chronic pericarditis?

In the case of acute inflammation, pericarditis may be linked to a viral or bacterial infection (in most cases), but also to kidney failure, certain types of cancer (breast, lung) and myocardial infarction (Dressler's syndrome). Acute pericarditis can also occur after taking certain medicines or, more rarely, after a vaccination. Chronic pericarditis, for its part, is also favoured by kidney failure, tuberculosis and various cancers (effusive pericarditis), but also by a viral or bacterial infection, a thoracic lymphoma or cardiovascular surgery (constrictive pericarditis).

As the definition of pericarditis indicates (inflammation of the pericardium), the condition mainly causes symptoms located near the heart, in the chest. These may include palpitations, chest pain, cough, dyspnoea (breathing difficulties), heart failure or a pericardial effusion. However, the signs are not very specific, so the onset of pericarditis may be accompanied by other symptoms, such as fever and fatigue. Finally, in pericarditis, pain – whether in the chest or the muscles – is often present, particularly on the left side; it is made worse by standing and relieved by sitting up. Fortunately, treatments for pericarditis exist that both treat the disease and prevent it from coming back.

As an inflammation of the pericardium, pericarditis can show itself through symptoms such as chest and muscle pain, dyspnoea (breathing difficulties), cough and palpitations, or increased fatigue and fever. If you have one or more signs of the disease, you should seek medical advice promptly. Acute pericarditis can be diagnosed by a doctor through a clinical examination and questioning, combined with an electrocardiogram (ECG). The presence of a pericardial effusion can be confirmed by echocardiography. Finally, CT scanning and magnetic resonance imaging (MRI) can assess the thickening of the pericardium that is characteristic of chronic constrictive pericarditis.

Pericarditis, whether acute or chronic, causes non-specific symptoms, notably chest and muscle pain, which can be very severe in some people. There are treatments for pericarditis that relieve the pain, treat the condition and prevent it from recurring. Rest, painkillers and anti-inflammatory drugs, or even steroids, are usually prescribed, together with treatment of the underlying cause of the pericarditis, such as a bacterial infection. More rarely, a pericardiotomy (surgical incision of the pericardium in the case of a pericardial effusion) may be considered.

Together with various medicines, rest is part of the treatment of pericarditis. But it also helps to prevent the condition, as does a healthy lifestyle.

Pericarditis is often linked to a viral or bacterial infection, but it can also result from kidney failure and certain types of cancer. It is therefore important to seek medical advice promptly if you have symptoms of pericarditis, as this makes it possible to relieve the inflammation of the pericardium, treat the cause and avoid any risk of fatal pericarditis. Idiopathic pericarditis (pericarditis of unknown cause) and acute pericarditis caused by an infection usually clear up within a few weeks; however, they can become chronic or lead to complications if left untreated: these include chronic constrictive pericarditis and complications such as heart failure and cardiac tamponade (build-up of blood or fluid in the pericardial sac).

This information is provided for guidance only and does not replace a medical consultation.