Tightness in the chest that radiates out toward your left shoulder and into your neck. Stabbing chest pain. Difficulty breathing. Coughing and a general feeling of malaise. Weakness, shortness of breath – many of these symptoms point to a heart attack, and while it certainly makes sense that a person experiencing these thinks they’re having a heart attack, what this individual really could be experiencing is pericarditis. Pericarditis is good at mimicking heart attack symptoms.
Pericarditis affects the pericardium, a saclike membrane that surrounds the heart. Its job is to attach the heart to where it needs to go in the thoracic cavity, protect the heart from infection, and provide lubrication for the heart. Like almost any part of a body, the pericardium can suffer damage. Most often, this comes in the form of pericarditis.
Pericarditis and Its Complications
Swelling and irritation of the pericardium is what doctors refer to as pericarditis. The pericardium becomes inflamed and, over time, the swelling and irritation result in fluid accumulation between the pericardial space – in other words, between the two layers of the pericardium. This results in heart attack-like symptoms. If pericarditis symptoms are left unchecked, the condition can result in serious complications: cardiac tamponade and chronic constrictive pericarditis.
Cardiac tamponade is the direct result of fluid buildup in the saclike membrane of the pericardium. This excess fluid puts extra pressure on the heart, which can prevent it from properly filling with blood. This means that less blood leaves your heart to be circulated through the body. This sharp drop in blood pressure can be fatal if you don’t see your doctor to get it checked.
Chronic constrictive pericarditis is more rare than cardiac tamponade and takes longer to develop, but it results in scar-like tissue forming in the pericarditis. This makes the membrane stiff and difficult to move, which means the scarred tissue compresses the heart and doesn’t allow it to function properly. Signs of this include chest pain, fever, weakness, coughing, heart palpitations, dry cough, difficulty breathing, or swelling in the stomach or legs.
Key Risk Factors
Now that you know what symptoms to look for, it’s also a good idea to know what risk factors you might have, how pericarditis is diagnosed and how it can be treated. You’re more at risk for pericarditis if you:
- Are recovering from a heart attack
- Have experienced trauma from an injury or accident
- Are experiencing kidney failure
- Have specific bacterial, viral, or fungal infections
- Have certain autoimmune disorders
If you have these risk factors or are experiencing symptoms, your doctor will likely perform tests, such as a chest X-ray, a CT scan, or an electrocardiogram. If it’s determined that you have pericarditis and it hasn’t progressed too far, it can likely be treated with either IV or oral steroids or other anti-inflammatory medications. In extreme cases, your doctor might recommend removing the built-up fluid from the pericardium or remove the pericardium completely.
Regardless of whether you’re experiencing pericarditis, don’t try to diagnose anything on your own. If you’re experiencing chest pain, it needs to be considered an emergency situation until you can be properly diagnosed.
Dr. Wagle is a board-certified cardiologist at Kelsey-Seybold. He cares for patients at Katy Clinic and Tanglewood Clinic. His clinical interests include coronary artery disease, heart failure, arrhythmias, valvular heart disease, echocardiography, nuclear cardiology, preventive cardiology, chest pain, hypertension, high cholesterol, and myocardial infarctions.