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The heart is surrounded by a thin, protective sac called the pericardium. This sac has two layers with a small amount of fluid between them, allowing the heart to move smoothly as it beats.

Sometimes, the pericardium becomes inflamed. This condition is called pericarditis. It can cause chest pain and other symptoms that may be uncomfortable or alarming. In many cases, pericarditis improves with treatment, but some forms can lead to complications and require medical attention.

What Is Pericarditis?

Pericarditis is inflammation of the pericardium, the protective sac surrounding the heart.

Inflammation can cause the two layers of the pericardium to become irritated. This often produces sharp chest pain that may change depending on your body position or breathing.

Pericarditis can affect people of different ages and may develop suddenly or gradually.

What Causes Pericarditis?

There are many possible causes of pericarditis. In some cases, doctors may not be able to identify a specific cause.

Possible causes include:

• Viral infections

• Bacterial infections

• Other infections

• Autoimmune conditions

• Injury to the chest

• Heart surgery or certain heart procedures

• Kidney disease

• Cancer

• Certain medications

• Radiation treatment

A healthcare professional may perform tests to determine what is causing the inflammation and whether an underlying condition needs treatment.

What Does Pericarditis Chest Pain Feel Like?

Chest pain is one of the most common symptoms of pericarditis.

The pain is often described as sharp or stabbing and may occur in the center or left side of the chest. It may become worse when taking a deep breath, coughing, or lying down.

One feature that can help distinguish pericarditis pain from some other types of chest pain is that it may improve when sitting up and leaning forward.

However, chest pain can have many causes, including serious heart and lung conditions. You should not try to diagnose the cause of chest pain based only on how it feels.

What Are Other Symptoms of Pericarditis?

In addition to chest pain, pericarditis may cause:

• Shortness of breath

• Weakness or tiredness

• Fever

• Cough

• Heart palpitations

• Pain that spreads to the shoulder or neck

• A feeling of discomfort when lying down

Symptoms can vary depending on the cause and severity of the inflammation.

Some people may have mild symptoms, while others can experience significant chest discomfort.

Why Can Breathing Make Pericarditis Pain Worse?

The inflamed pericardium can become irritated as the heart and surrounding structures move.

Deep breathing can increase this irritation, causing chest pain to become more noticeable. Coughing or certain body movements may also make the pain worse.

Because other conditions can cause chest pain that changes with breathing, medical evaluation is important when symptoms are new or unexplained.

Can Pericarditis Cause a Fever?

Yes. A mild fever can occur, particularly when pericarditis is related to an infection or inflammation elsewhere in the body.

Fever combined with chest pain, shortness of breath, or other concerning symptoms should be evaluated by a healthcare professional.

Who Is More Likely to Develop Pericarditis?

Pericarditis can occur in anyone, but certain conditions may increase the risk.

People who have recently experienced a viral infection, heart surgery, chest injury, or certain inflammatory diseases may have a higher risk.

People with kidney disease or certain autoimmune disorders may also be more likely to develop inflammation around the heart.

How Is Pericarditis Diagnosed?

Doctors use a combination of medical history, symptoms, physical examination, and testing.

A healthcare professional may perform:

• An electrocardiogram

• Blood tests

• An echocardiogram

• A chest X-ray

• CT or MRI imaging when needed

During an examination, a doctor may sometimes hear a characteristic sound called a pericardial friction rub, which can occur when the inflamed layers of the pericardium rub against each other.

How Is Pericarditis Treated?

Treatment depends on the underlying cause and severity.

For some people, treatment may involve medicines that reduce inflammation and relieve pain. If an infection or another underlying condition is responsible, that condition may also need treatment.

Rest may be recommended during recovery, particularly when physical activity could worsen symptoms or increase the risk of complications.

People should follow their healthcare professional's treatment instructions rather than treating persistent chest pain on their own.

Can Pericarditis Cause Complications?

Most cases of acute pericarditis improve with appropriate treatment, but complications can occur.

One possible complication is pericardial effusion, which happens when excess fluid builds up around the heart.

If too much fluid accumulates, it can put pressure on the heart and prevent it from filling properly. This serious condition is called cardiac tamponade and requires urgent medical treatment.

Another possible complication is constrictive pericarditis, in which the pericardium becomes thick or scarred and interferes with normal heart function.

When Should You Seek Emergency Care?

Chest pain should always be taken seriously, especially when its cause is unknown.

Seek emergency medical attention if chest pain is severe, sudden, persistent, or accompanied by:

• Difficulty breathing

• Fainting

• Severe weakness

• Confusion

• A very rapid heartbeat

• Bluish or pale skin

• Heavy sweating

These symptoms can occur with serious heart and lung conditions and should not be assumed to be caused by pericarditis.

FAQs

What is pericarditis?

Pericarditis is inflammation of the pericardium, the protective sac surrounding the heart.

What is the most common symptom of pericarditis?

Sharp chest pain is one of the most common symptoms. The pain may worsen when lying down or taking a deep breath and may improve when sitting up and leaning forward.

Can pericarditis cause shortness of breath?

Yes. Shortness of breath can occur, particularly when lying down or when inflammation or fluid around the heart affects normal heart function.

Is pericarditis dangerous?

Many cases are treatable and improve with proper care. However, complications such as significant fluid buildup around the heart can be serious.

Conclusion

Pericarditis is inflammation of the protective sac surrounding the heart. One of its most common symptoms is sharp chest pain that may become worse when lying down, taking a deep breath, or coughing and may improve when sitting up and leaning forward.