Danger level: High

What is it?

Acute pericarditis is an inflammation of the heart’s cover.

Who gets it?

Acute pericarditis is more common in men than women. It’s more common in adults than in children.

What causes it?

Around our heart there is a sac, called the pericardium. It’s job is to protect the heart and reduce the friction between the heart and the surrounding organs when it’s pumping.

This drawing shows what’s left when you take the heart out – its cover, the pericardium.

A bunch of things can cause this sac to get inflamed (like we mentioned here before, when something in medicine ends with an “itis” it means it’s inflamed). Here are a few of them:

1. Infection – Mostly viruses.
2. Radiation – People who had radiation to their chests in the past (such as for a tumor) are in more danger of developing pericarditis.
3. Injury – An injury to the chest, such as in car accidents (when the wheel hits the chest) or when a knife or bullet hit the area.
4. After a heart attack – This is one of the complications that can happen as a result of a heart attack.
5. Drugs – There are certain drugs that can cause this.
6. Kidney failure
7. Tumors – When some tumors (such as breast cancer, lung cancer or Hodgkin’s lymphoma) spread to the heart, they can cause this.
8. Lupus and rheumatoid arthritis – Can cause pericarditis as part of the disease. (There are also other similar disease which can cause this).
9. Inflammatory bowel diseases – Such as crohn’s disease or ulcerative colitis.

But most of the time, the cause is simply unknown.

(There are still other reasons, such as tuberculosis and others).

How does it feel?

The basic feature of pericarditis is chest pain. The pain is sharp and can radiate to the trapezius muscle (the muscle between our shoulders, on both sides of the neck). It gets worse by breathing and by lying down, and gets better when you lean forward.

Sometimes fever can accompany the pain.

How is it discovered?

There are a few things the doctor can do to tell if you have pericarditis:

1. Listen to your heart – A special sound called a “pericardial friction rub” is heard when you listen to the heart in this condition. It’s causes by the rubbing of the layers of inflamed sac around the heart.
2. Do an ECG – Like in a heart attack, here too, the ECG has a special pattern which the doctor can recognize (and which is different than the one in a heart attack).
3. X-ray of the chest or an echocardiogram – An echocardiogram is an ultrasound of the heart. As you’ll read ahead, pericarditis can lead to fluid in the sac surrounding the heart (called a pericardial effusion). The echo can discover that.

How is it treated?

There are a few things used to treat pericarditis:

1. Aspirin or anti-inflammatory drugs – These are used to control the pain and the inflammation.
2. Treating the cause – Such as an infection.

What happens after treatment?

Usually the outcome of the disease is good if it’s caused by a virus or by some unknown cause, and if it’s treated on time. Most people recover in 2 weeks to 3 months (even though it may return).

If not treated, pericarditis can cause complications:

1. Pericardial effusion – This is a buildup of fluid around the heart.
2. Cardiac tamponade – If a fluid builds up too quickly around the heart, the heart may suddenly develop difficulties pumping the appropriate volume of blood it’s used to, since the fluid takes all the space around it. This is a life threatening situation.
3. Constrictive pericarditis – This can happen in a longstanding disease. The sac around the heart gets stiff and thick, which makes it harder for the heart to pump blood.

(We’ll cover these conditions in future posts).

Acute pericarditis usually can’t be prevented. But you can prevent it from coming back by treating it properly.

This video shows the story of attorney David Geller, 26, who suffered from the disease for months until it was treated properly:

What next?

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Related posts:

1. Acute Pancreatitis – A Dangerous Condition Which Can Be Caused by Drinking Alcohol
2. Understanding Heart Attacks – Part 2 – Angina Pectoris
3. Understanding Heart Attacks – Part 3 – Myocardial Infarction
4. Chest Pain – Is It a Heart Attack?
5. As Seen on Grey’s Anatomy – Acute Porphyria