Pericarditis: Symptoms, Causes, Treatment
التهاب التامور
Pericarditis is inflammation of the sac surrounding the heart and may cause chest pain or fluid accumulation. New chest pain needs assessment for serious causes; relief on leaning forward is not enough to establish the diagnosis.
What is Pericarditis?
It can be a first episode, persistent or recurrent, and may accompany heart-muscle inflammation. Fluid around the heart does not always mean pericarditis. Symptoms and tests determine cause, severity and the need for treatment or observation.
Related reading: What are heart attack symptoms, and when should I call for help?.
Symptoms
Pain may be sharp, worse with deep breathing or lying down, and relieved by sitting forward. Fever or breathlessness may occur. These features do not exclude a heart attack or pulmonary embolism and cannot establish safety at home.
Causes
No definite cause is found in many cases, sometimes with a suspected viral trigger. Other causes include autoimmune disease, specific infections, kidney failure, cardiac surgery or injury and certain medicines. Management changes when a specific cause needs treatment.
Risk factors
Pericarditis affects different age groups. Infection, autoimmune or kidney disease, cardiac surgery and medicines influence risk according to the case. Prior pericarditis makes recurrent pain important to assess but does not prove every later pain has the same cause.
Diagnosis
Assessment includes examination, ECG, inflammation and cardiac-injury blood tests, and echocardiography. Other imaging or MRI may clarify inflammation and complications. Positional pain alone is insufficient, and effusion size alone does not determine danger.
Treatment
Suitable cases may receive an anti-inflammatory medicine and colchicine, with dose and duration adjusted for weight, kidney function, interactions and cause. Some need cause-specific or recurrent-disease treatment. Drainage depends on cardiac effects and other indications, not merely a large effusion.
Complications
Possible complications include recurrence, fluid compressing the heart in cardiac tamponade and, in some cases, constrictive pericarditis. The heart muscle may also be involved. Risk assessment and monitoring identify patients needing hospital care.
Prevention
Not all episodes are preventable. Following treatment, addressing causes and avoiding an early return to strenuous exercise support recovery. Symptoms and follow-up tests guide activity. Do not shorten therapy or self-start steroids or leftover colchicine.
When to see a doctor
Call emergency services for severe or persistent chest pain with breathlessness, sweating or fainting; do not drive yourself. New chest pain needs medical assessment even if it resembles an earlier episode. Report recurrence, fever or deterioration during treatment.