Pericarditis

Pericarditis
An ECG showing pericarditis. Note the ST elevation in multiple leads with slight reciprocal ST depression in aVR.
Classification and external resources
Specialty	Cardiology
ICD-10	I01.0, I09.2, I30–I32
ICD-9-CM	420.0, 420.90, 420.91, 420.99, 423.1, 423.2
DiseasesDB	9820
MedlinePlus	000182
eMedicine	med/1781 emerg/412
MeSH	D010493
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Pericarditis is inflammation of the pericardium (the fibrous sac surrounding the heart). Symptoms typically include sudden onset of sharp chest pain. The pain may also be felt in the shoulders, neck, or back. It is typically better sitting up and worse with lying down or breathing deep. Other symptoms may include fever, weakness, palpitations, and shortness of breath. Occasionally onset of symptoms is gradual.

The cause of pericarditis is believed to be most often due to a viral infection. Other causes include bacterial infections such as tuberculosis, uremic pericarditis, following a heart attack, cancer, autoimmune disorders, and chest trauma. The cause often remains unknown. Diagnosis is based on the chest pain, a pericardial rub, specific electrocardiogram (ECG) changes, and fluid around the heart. Other conditions that may produce similar symptoms include a heart attack.

Treatment in most cases is with NSAIDs and possibly colchicine. Steroids may be used if those are not appropriate. Typically symptoms improve in a few days to weeks but can occasionally last months. Complications can include cardiac tamponade, myocarditis, and constrictive pericarditis. It is a less common cause of chest pain. About 3 per 10,000 people are affected per year. Those most commonly affected are males between the ages of 20 and 50. Up to 30% of those affected have more than one episode.

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