- Chest pain, caused by the inflamed pericardium rubbing against the heart.
- Usually relieved with sitting
- Pleuritis type: a sharp, stabbing pain
- May radiate to the neck, shoulder, back or abdomen
- Increases with deep breathing
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- Breathing difficulty when lying down (the patient prefers standing or sitting upright)
- Splinting of ribs (bending over or holding the chest) with breathing
- Dry cough
- Difficulty swallowing
- Hiccups
- Ankle, feet and leg swelling (occasionally)
- Anxiety
- Fatigue
- Fever
Treatment
The cause of pericarditis must be identified, if possible.
In most types of pericarditis, it is necessary to treat the pain with analgesics (pain killers). The inflammation of the pericardium is treated with anti-inflammatory drugs(NSAIDS) such as aspirin and ibuprofen; in some cases, corticosteroids may be prescribed.
Diuretics may be used to remove excess fluid accumulated in the pericardial sac. If the buildup of pericardial fluid makes the heart function poorly or produces cardiac tamponade, it is necessary to drain the fluid through pericardiocentesis (removal of excess fluid from the pericardial sac). Pericardiocentesis may be either percutaneous (using a needle to reach the pericardium, guided with echocardiography, in the procedure room), or surgical (done in the operating room as a minor surgery).
Bacterial pericarditis should be treated with antibiotics. Fungal pericarditis should be treated with antifungal agents.
If the pericarditis is chronic, recurrent, or results in constrictive pericarditis, it may be advisable to perform pericardiectomy (cutting or removal of part of the pericardium).
