Pericarditis describes the condition in which the pericardium, the thin membrane surrounding the heart, becomes inflamed and irritated. Sharp chest pains associated with pericarditis occur when the two layers of the pericardium rub against each other. Acute pericarditis usually lasts only a few weeks, while chronic pericarditis persists for months and develops gradually.
Pericarditis is usually a complication of viral infections, most commonly echovirus or coxsackie virus. Sometimes, the disorder may develop after a heart attack, secondary to the irritation of the heart muscle underlying the pericardium. In rare cases, it is associated with influenza or HIV infections. Often, the cause of the condition is unknown.
In more severe forms of pericarditis, the inflamed layers of the pericardium might stiffen and develop scar tissue (constrictive pericarditis).
If the tissue becomes thickened and sticks together, limiting the heart’s normal filling, symptoms may resemble heart failure. Alternatively, fluid may fill the space between the layers of the pericardium, causing a pericardial effusion. If the build-up is rapid, it can further lead to cardiac tamponade, a potentially life-threatening condition that impairs heart functions and requires emergency drainage.
With acute pericarditis, the most common symptom is sharp, stabbing pain behind the breastbone or in the left side of your chest. Sometimes, the pain can be dull and achy with varying intensity. The pain may also travel into your left shoulder and across your neck, intensifying when you lie down or inhale deeply. It eases when you sit up or lean forward.
Chronic pericarditis, however, is less intense and often painless and is associated with excess fluid developing around the heart (pericardial effusion). The most common symptom of chronic pericarditis is shortness of breath. Other symptoms of both forms of this disorder are similar to those related to other heart-related conditions. These include:
- Shortness of breath even with limited activity
- Swelling of the feet, ankles, hands or abdomen
- Rapid or irregular heartbeat or pulse
- Dizziness or fainting
- Anxiety or fatigue
Pericarditis most often affects men aged 20 to 50 and usually follows respiratory infections. In children, it is most often caused by adenovirus or coxsackie virus.