Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed. Often pericarditis affects men ages 20-50 and the cause is usually unknown or unproven.

Pericarditis may result from an infection such as:

  • Viral infections that cause a chest cold or pneumonia, such as the echovirus or coxsackie virus (which are common in children), as well as influenza
  • Infections with bacteria (much less common)
  • Some fungal infections (even more rare)

Or be seen with diseases such as:


When listening to the heart with a stethoscope, the health care provider can hear a sound called a pericardial rub. The heart sounds may be muffled or distant. There may be other signs of fluid in the pericardium (pericardial effusion).

If the disorder is severe, there may also be:

  • Crackles in the lungs
  • Decreased breath sounds
  • Other signs of fluid in the space around the lungs (pleural effusion)

Imaging tests may be done to check the heart and the tissue layer around it (pericardium), such as:

To look for heart muscle damage, the health care provider may order a troponin I test. Other laboratory tests may include:


Chest pain is almost always present with pericarditis. Pain in the neck, shoulders, back or abdomen are also common, and may increase with deep breathing, lying flat, coughing or swallowing. The pain can be a severe, sharp pain, and often the only relief is from leaning or bending forward.

Other symptoms include:

  • Ankle, feet, and leg swelling (occasionally
  • Anxiety
  • Breathing difficulty when lying down
  • Dry cough
  • Fatigue
  • Fever, chills or sweating (if caused by an infection)


To treat pericarditis, high dosees of High doses of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are often given. These medicines decrease pain and reduce the swelling or inflammation in the sac around of the heart.

If the cause of pericarditis is an infection:

  • Antibiotics will be used for bacterial infections
  • Antifungal medications will be used for fungal pericarditis

Other medicines that may be used are:

  • Corticosteroids such as prednisone (in some patients)
  • "Water pills" (diuretics) to remove excess fluid

If pericarditis is chronic, or causes scarring or tightening of the tissue around the heart, a pericardiectomy may be necessary, or surgery to removing part of the pericardium.


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