Acute Pericarditis

Causes of acute pericarditis include

In people who have AIDS, a number of infections, including tuberculosis Tuberculosis (TB) Tuberculosis is a chronic contagious infection caused by the airborne bacteria Mycobacterium tuberculosis. It usually affects the lungs, but almost any organ can be involved. Tuberculosis... read more and aspergillosis Aspergillosis Aspergillosis is an infection, usually of the lungs, caused by the fungus Aspergillus. A ball of fungus fibers, blood clots, and white blood cells may form in the lungs or sinuses. People... read more , may result in pericarditis. Pericarditis due to tuberculosis (tuberculous pericarditis) accounts for less than 5% of cases of acute pericarditis in the United States but accounts for the majority of cases in some areas of India and Africa. SARS-CoV-2 COVID-19 COVID-19 is an acute respiratory illness that can be severe and is caused by the coronavirus named SARS-CoV-2. Symptoms of COVID-19 vary significantly. Two types of tests can be used to diagnose... read more infection infrequently causes pericarditis.

After a heart attack, acute pericarditis develops during the first day or two in 10 to 15% of people and after about 10 days to 2 months in 1 to 3% (subacute pericarditis). Subacute pericarditis is caused by the same disorders that cause acute pericarditis.

Usually acute pericarditis causes sharp chest pain, which often extends to the left shoulder and sometimes down the left arm. The pain may be similar to that of a heart attack, except that it tends to be made worse by lying down, swallowing food, coughing, or even deep breathing. The accumulating fluid or blood in the pericardial space puts pressure on the heart, interfering with its ability to pump blood. If the pressure is too high, cardiac tamponade Cardiac Tamponade Cardiac tamponade is pressure on the heart by blood or fluid that accumulates in the two-layered sac around the heart (pericardium). This disorder interferes with the heart's ability to pump... read more —a potentially fatal condition—may occur. Sometimes acute pericarditis does not cause any symptoms.

Pericarditis due to tuberculosis begins insidiously, sometimes without obvious symptoms of infection. It may cause fever and symptoms of heart failure, such as weakness, fatigue, and difficulty breathing. Cardiac tamponade may occur.

Acute pericarditis due to a viral infection is usually painful but short-lived and has no lasting effects.

When acute pericarditis develops in the first day or two after a heart attack Acute Coronary Syndromes (Heart Attack; Myocardial Infarction; Unstable Angina) Acute coronary syndromes result from a sudden blockage in a coronary artery. This blockage causes unstable angina or a heart attack (myocardial infarction), depending on the location and amount... read more , symptoms of pericarditis are seldom noticed because symptoms of the heart attack are the main concern.

Pericarditis that develops about 10 days to 2 months after a heart attack is usually accompanied by postmyocardial infarction syndrome Pericarditis The heart muscle needs a constant supply of oxygen-rich blood. The coronary arteries, which branch off the aorta just after it leaves the heart, deliver this blood. An acute coronary syndrome... read more (Dressler syndrome), which includes fever, pericardial effusion (extra fluid in the pericardial space), pleuritic pain (pain due to inflammation of the pleura, which are the membranes covering the lungs), pleural effusion (fluid between the two layers of the pleura), and joint pain.

Symptoms of acute pericarditis often go away on their own but come back in up to 30% of people.

In 15 to 25 percent of people with idiopathic pericarditis, symptoms recur on and off for months or years (called recurrent pericarditis).

Doctors can usually diagnose acute pericarditis based on the person's description of the pain and the sounds heard by listening through a stethoscope placed on the person's chest. Pericarditis can cause a crunching sound similar to the creaking of a leather shoe or a scratchy sound similar to the rustling of dry leaves (pericardial rub). Doctors can often diagnose pericarditis a few hours to a few days after a heart attack based on hearing these sounds.

Usually, doctors also do electrocardiography Electrocardiography Electrocardiography (ECG) is a quick, simple, painless procedure in which the heart’s electrical impulses are amplified and recorded. This record, the electrocardiogram (also known as an ECG)... read more (ECG), which often shows abnormalities caused by the pericarditis. Then doctors look for signs of pericardial effusion by doing a chest x-ray and echocardiography Echocardiography and Other Ultrasound Procedures Ultrasonography uses high-frequency (ultrasound) waves bounced off internal structures to produce a moving image. It uses no x-rays. Ultrasonography of the heart (echocardiography) is one of... read more (a procedure that uses ultrasound waves to produce an image of the heart).

The prognosis for people who have pericarditis depends on the cause. When pericarditis is caused by a virus or when the cause is not apparent, recovery usually takes 1 to 3 weeks. Complications or recurrences can slow recovery. People with cancer that has invaded the pericardium rarely survive beyond 12 to 18 months.

Regardless of the cause, doctors sometimes hospitalize people with pericarditis, particularly people with high-risk features (fever, subacute onset, use of immunosuppressive drugs, recent trauma, oral anticoagulant therapy, failure to improve with use of aspirin or nonsteroidal anti-inflammatory drugs Nonsteroidal Anti-Inflammatory Drugs Pain relievers (analgesics) are the main drugs used to treat pain. Doctors choose a pain reliever based on the type and duration of pain and on the drug's likely benefits and risks. Most pain... read more [NSAIDs], myopericarditis [pericarditis involving the heart muscle as well as the pericardium] and moderate or large pericardial effusions). The person is monitored for complications, particularly cardiac tamponade.