Pericarditis is an inflammatory condition that affects the pericardium, the thin sac that surrounds the outside of the heart. Swelling and inflammation in the pericardium can cause severe chest pain that can last for weeks or months.
In many cases, pericarditis goes away on its own. When treatment is needed, some patients may only need rest and medication. However, some patients experience pericarditis for a prolonged period of time. When this happens, it can lead to other complications.
Diagnosing pericarditis in the early stages is important. If the condition progresses, it may cause:
This condition occurs when excessive amounts of fluid accumulate in the pericardium. The additional fluid strains the heart and reduces its ability to pump blood to the rest of the body.
Cardiac tamponade occurs when fluid accumulation in the pericardium restricts the amount of blood coming into and out of the heart, resulting in severely low blood pressure. This is a life-threatening condition that requires an emergency procedure to drain fluid from the pericardium.
Patients with chronic pericarditis may experience a thickening of the heart’s lining, known as constrictive pericarditis. This complication of pericarditis causes the pericardium to create scar tissue which reduces the heart’s ability to pump blood. Constrictive pericarditis can also cause swelling in the feet, legs or abdomen, irregular heartbeat (arrhythmia) or heart failure.
Pericarditis is categorized based on how long it lasts.
Pericardial inflammation develops suddenly and produces significant symptoms. These symptoms are often similar to symptoms of heart attack, including severe chest pain. Acute pericarditis lasts fewer than six weeks.
Pericarditis that lasts between six weeks and three months is called incessant pericarditis. Patients will experience symptoms consistently throughout this time period.
Pericarditis that lasts longer than three months is known as chronic pericarditis.
All types of pericarditis may reoccur in the future, after symptoms have been initially resolved. A small percentage of people will have episodes of pericarditis, off and on, for multiple years.
In most cases, the cause of pericarditis is unknown. Sometimes pericarditis results from one of the following conditions:
In most cases, the cause of pericarditis is unknown. Sometimes pericarditis results from one of the following conditions:
Because the cause of pericarditis is usually unknown, it may not be possible to prevent it. Anyone can develop pericarditis, but it is seen most frequently in males between the ages of 15 and 65.
People with the following characteristics may have an increased risk:
Diagnosing pericarditis begins with a physical exam by a health care provider, including listening to the heart with a stethoscope. Pericarditis makes a unique sound called the “pericardial rub” that occurs when layers of the pericardium rub together. The health care provider may also hear a crackling sound in the lungs.
If pericarditis is suspected, additional testing may be recommended. These tests can include:
Pericarditis does not always require treatment. When treatment is needed, it can include medication or a procedure to drain fluid from the pericardium.
Medications are used to control symptoms of pericarditis and to resolve the underlying cause if it is known. Anti-inflammatory medications or steroids are often used to reduce pain and inflammation. Diuretics can reduce fluid build-up.
If pericarditis is caused by a bacterial infection, prescription antibiotics can be used to treat the infection. Immunosuppressant medications are used when autoimmune conditions cause pericarditis.
Sometimes a procedure is needed to drain excess fluid from the pericardium to restore the heart’s ability to pump blood effectively. Depending on the type and severity of pericarditis, either a minimally invasive procedure or surgery will be recommended.
Pericardiocentesis
This is a minimally invasive procedure to drain fluid from the pericardium. Using image-guided technology, a heart specialist inserts a small needle and catheter (long, thin tube) into the heart lining to remove fluid.
Pericardial Window
If a small-needle procedure (pericardiocentesis) is not sufficient to remove the fluid, a pericardial window procedure may be recommended. This involves creating a small incision in the chest to reach the pericardium and drain the fluid.
Pericardiectomy
Patients with chronic pericarditis that has progressed to constrictive pericarditis may need a portion or all of their pericardium removed. This surgical procedure is performed to remove scar tissue that has caused the pericardium to be stiff and inflexible.
The nationally recognized heart specialists affiliated with Memorial Hermann work collaboratively with care teams and patients to effectively treat and manage pericarditis. From diagnosis to treatment and management, our esteemed providers utilize the latest clinical advancements and a patient-focused approach to assess each patient’s condition to identify the most appropriate path forward to yield the best possible results.
If you’d like a referral to a heart and vascular specialist or want more information about our services, please fill out the form below. For other inquiries, such as obtaining medical records, imaging reports or test results, please call (713) 222-CARE (2273).