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Definition Return to top
Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.
See also: Bacterial pericarditis
Causes Return to top
Pericarditis is usually a complication of viral infections, most commonly echovirus or coxsackie virus. Less frequently, it is caused by influenza or HIV infection.
Infections with bacteria can lead to bacterial pericarditis (also called purulent pericarditis). Some fungal infections can also produce pericarditis.
In addition, pericarditis can be associated with diseases such as:
Other causes include:
Often the cause of pericarditis remains unknown. In this case, the condition is called idiopathic pericarditis.
Pericarditis most often affects men aged 20-50. It usually follows respiratory infections. In children, it is most commonly caused by adenovirus or coxsackie virus.
Symptoms Return to top
Exams and Tests Return to top
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 be:
If fluid has built up in the pericardial sac, it may show on:
These tests show:
Other findings vary depending on the cause of pericarditis.
To rule out heart attack, the health care provider may order serial cardiac marker levels (CK -MB and troponin I). Other laboratory tests may include:
Treatment Return to top
The cause of pericarditis must be identified, if possible.
If the buildup of fluid in the pericardium makes the heart function poorly or produces cardiac tamponade, it is necessary to drain the fluid from the sac. This procedure, called pericardiocentesis, may be done using an echocardiography-guided needle or a minor surgery.
If the pericarditis is chronic, recurrent, or causes constrictive pericarditis, cutting or removing part of the pericardium may be recommended.
Outlook (Prognosis) Return to top
Pericarditis can range from mild cases that get better on their own to life-threatening cases. The condition can be complicated by significant fluid buildup around the heart and poor heart function.
The outcome is good if the disorder is treated promptly. Most people recover in 2 weeks to 3 months. However, pericarditis may come back.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your health care provider if you experience the symptoms of pericarditis. This disorder can be life-threatening if untreated.
Prevention Return to top
Many cases are not preventable.
References Return to top
LeWinter MM. Pericardial Diseases. In: Libby P, Bonow RO, Mann DL, Zipes DP. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 70.Update Date: 5/15/2008 Updated by: Alan Berger, MD, Assistant Professor, Divisions of Cardiology and Epidemiology, University of Minnesota, Minneapolis, MN. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.