Clinical Overview
Reviewed by Reviewed by Dr. Michael Fuller

Pericarditis is an inflammation of the pericardium, the fluid-filled sac surrounding the heart. Pericarditis may occur as a mild symptom of a viral infection.

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In that case it can be treatable with medication, or it may will resolve itself on its own. It can, however, lead to heart failure or other serious conditions.

The pericardium is a thin, permeable sac that surrounds the heart. Its purpose is to keep the heart in place, prevent the heart from overfilling with blood, and protect the heart from infections. Fluid between the pericardium and the heart (pericardial fluid) enables the two to move without friction between them.

Pericarditis is an inflammation of the pericardium. When the pericardium is inflamed, fluid can accumulate between it and the heart. This can increase pressure on the heart and cause fluid to leak out into the body. The pericardium can also rub against the heart, causing friction and pain. Eventually, in chronic cases, the sac can lose elasticity, scar, and actually adhere to the heart.

There are two main types of pericarditis, acute and chronic. Acute pericarditis is sharp and temporary, while chronic pericarditis builds up gradually and lasts longer. Constrictive pericarditis is a complication that can arise in chronic cases; in this case, scar tissue forms around the heart and gradually compresses it, causing fluid to leak out of the heart and accumulate under the skin, in the abdomen or around the lungs. Constrictive pericarditis also means that the heart cannot properly fill with blood. This can lead to right-sided heart failure.



Cardiac tamponade is a life-threatening complication that can develop from pericarditis. It occurs when fluid builds up rapidly and puts pressure on the heart. This condition can also develop independently of the inflammation that characterizes pericarditis, caused by many of the same factors, including lupus, recent heart attack, kidney failure or injury.

Causes


Any number of infections and conditions may cause pericarditis. The same conditions can cause either acute or chronic pericarditis, or cardiac tamponade. Usually, however, the cause is unknown.

• Viral infections such as the mumps, mononucleosis (mono), tuberculosis, AIDS or hepatitis B
  
• Prior heart attack. About 5% of heart attack survivors will develop pericarditis as a symptom. Usually it develops with a week, but it can still occur up to three months after the attack.
  
• Lupus Erythematosus
  
• Cancer, including leukemia(cancer of the blood cells)
  
• Kidney failure
  
• Aortic aneurysm
  
• Rheumatoid arthritis
  
• As a side effect of certain drugs, including anticoagulants, penicillin, procainamide, phenytoin, and phenylbutazone
  
• Radiation treatment for breast cancer or lymphoma
  

Last updated: Feb-25-08