Symptoms and Signs of Pericarditis

Medical Author:
Medically Reviewed on 10/6/2021

Doctor's Notes on Pericarditis

Pericarditis is the condition where the thin membrane that lines the outside of the heart becomes inflamed. It can be double layered and normally holds less than 50 mL of fluid. Signs and symptoms of pericarditis are mainly chest pain described as sharp and pleuritic (increases when the person takes a deep breath or increases when the patient lies flat or decreases when the patient leans forward). This pain can radiate to the back or left shoulder.

Associated symptoms are 

  • fever,
  • weakness, and
  • in some patients, swelling of the feet, ankles, and legs.

The most common cause of pericarditis is considered idiopathic, meaning the reason or cause cannot be determined. However, there are different known less frequent causes such as infections, especially viral types, bacterial infections (like TB), some parasites, and fungi. Other associated causes may be inflammatory diseases, kidney disorders, heart attacks, hyperthyroidism, cancers, radiation therapy, trauma, and as a side effect of some medications like procainamidephenytoin, and others.

What are the treatments for pericarditis?

The treatments for pericarditis depend on the cause and symptoms in an individual. Mild pericarditis may get better on its own but some individuals may require other interventions. For example:

  • Pain control (aspirin, ibuprofen, or prescription-strength)
  • Pericarditis caused by bacteria require antibiotic treatment
  • Pericarditis caused by inflammatory diseases usually need anti-inflammatory medication

If fluid increases or if the pericardial sac becomes restrictive to the heart, you may need treatments that involve surgery:

  • Pericardiocentesis – fluid drained from pericardial space by sterile needle or catheter
  • Pericardiectomy – removal of the entire pericardium 

Your doctors can help determine the treatments to reduce or stop your pericardial problems.  

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.