Pericarditis is the inflammation of the pericardium, or sac-like membrane that envelopes the heart. The pericardium cushions, anchors, and protects the heart muscle. The inflammation may be caused by bacterial infection, radiation therapy, the side effects of certain medications, kidney failure, tuberculosis, auto-immune disorders (such as lupus or rheumatoid arthritis), or certain forms of cancer. It may also develop after a heart attack. In cases where the cause of inflammation cannot be determined, it is termed idiopathic pericarditis.

What Are the Effects of Pericarditis?

Pericarditis causes chest pain that is especially acute beneath the ribcage and sternum. This pain may also be felt occur in the shoulder, neck and upper back. It is often aggravated by breathing, during which the movement of the heart and lungs in the chest cavity may irritate the pericardium. Changes in body position may increase or decrease the intensity of the discomfort. Pericarditis may be detected from an electrocardiogram (ECG).

Normally, pericarditis is not life-threatening, though it may lead to pericardial effusion in which fluid accumulates between the pericardium and the heart muscle. This may cause difficulty in breathing (dyspnea) and exert pressure on the heart chambers, making the heart work harder to pump blood to the lungs and body tissues. An echocardiogram is usually performed in patients suspected of pericarditis and will demonstrate the presence of increased fluid in the pericardial space (a pericardial effusion).

How Is Pericarditis Treated?

Anti-inflammatory medications such as aspirin, ibuprofen, and other non-steroidal anti-inflammatory drugs (NSAIDs) are effective in treating pericarditis. In some cases, steroids may be used.

The development of dyspnea may be a sign that the build-up of fluid around the heart has become severe and a periocardiocentesis is necessary. This involves the draining of the fluid by inserting a hollow tube through the chest wall.