Definition

Pericarditis is an inflammation of the sac around the heart. In some cases, the inflammation may cause fluid to build up in the sac and make it difficult for the heart to move.

Pericarditis
pericarditis
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Causes

The exact cause of pericarditis is often unknown. Infections, injuries or chronic disease may be involved in some cases.

Risk Factors

Factors that increase the risk for pericarditis include:

  • Weakened immune system that is not able to fight off infections and other diseases
  • Surgery to repair heart defects or heart disease
  • Infection from virus, bacteria, parasite, or fungus
  • Chest trauma or injury
  • Autoimmune disorders, like systemic lupus erythematosus

Symptoms

Chest pain is a common symptom. It may start over the left side or center of the chest and spread to the neck and left shoulder. The pain is usually a sharp, stabbing pain that may be worse with deep breathing or lying down.

Other symptoms may include:

  • Shortness of breath
  • Coughing
  • Fever and chills
  • Pain when swallowing
  • Weakness and fatigue
  • Irritability
  • Loss of appetite
  • Irregular heartbeat

Diagnosis

You will be asked about your child’s symptoms and medical history. A physical exam will be done. The doctor will listen for a grating or rubbing sound in your child’s heart. If the condition is severe, there may also be a crackle sound in your child’s lungs.

Images may be taken to evaluate the heart and surrounding tissue. This can be done with:

Your child's heart activity may be tested. This can be done with an electrocardiogram (EKG).

Your child's bodily fluids may be tested. This can be done with:

  • Blood tests
  • Pericardiocentesis

Treatment

The illness can range from mild to life-threatening. Acute inflammatory pericarditis usually improves with treatment within a few weeks or months. Pericarditis caused by chronic inflammatory diseases, like lupus or rheumatoid arthritis, may last longer or occur again.

Treatment options include:

Medication

The doctor may recommend medication to:

  • Decrease inflammation
  • Manage pain—may be over-the-counter or prescription medication depending on the degree of pain

Antibiotics may be given if the pericarditis is associated with a bacterial infection.

Procedures

For severe pericarditis, your child may need:

  • Pericardiocentesis—fluid around the heart is removed with a needle
  • Pericadiectomy—the sac around the heart is removed—rarely done

Prevention

There are no current guidelines to prevent pericarditis.

Revision Information

  • Reviewer: Kari Kassir, MD
  • Review Date: 12/2013 -
  • Update Date: 12/03/2013 -
  • American Heart Association

    http://www.heart.org

  • National Heart, Lung and Blood Institute

    http://www.nhlbi.nih.gov

  • Canadian Cardiovascular Society

    http://www.ccs.ca

  • Canadian Family Physician

    http://www.cfp.ca

  • Acute pericarditis. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated November 28, 2013. Accessed December 3, 2013.

  • Pediatric pericarditis. Cincinnati Children's website. Available at: http://www.cincinnatichildrens.org/health/info/heart/diagnose/peri.htm. Updated November 2013. Accessed December 3, 2013.

  • Pericarditis. Seattle Children's Hospital website. Available at http://www.seattlechildrens.org/medical-conditions/heart-blood-conditions/pericarditis-symptoms/. Accessed December 3, 2013.