Tightness in the chest that radiates out toward your left shoulder and into your neck. Stabbing chest pain. Difficulty breathing. Coughing and shortness of breath. Although these symptoms may point to a possible heart attack, they could also be an indication of pericarditis.
Pericarditis affects the pericardium, which is a saclike membrane that surrounds your 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.
What Is Pericarditis?
Swelling and irritation of the pericardium is what doctors refer to as pericarditis. The pericardium becomes inflamed and over time, the swelling and irritation results in fluid accumulation between the pericardial space – in other words, between the two layers of the pericardium. This results in those heart-attack-like symptoms you might be experiencing. If your pericarditis symptoms are left unchecked, the condition can result in serious complications – cardiac tamponade and chronic constrictive pericarditis, to be more specific.
Cardiac tamponade is the direct result of fluid buildup in the saclike membrane of the pericardium. The fluid in the pericardium puts extra pressure on the heart, which can prevent it from filling up with blood properly. This means less blood leaves the heart to be circulated through the body. This sharp drop in blood pressure can be fatal if you don’t see your doctor to have 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. Look for chest pain, fever, weakness, coughing, heart palpitations, dry cough, difficulty breathing or even swelling in your stomach or legs.
Risk Factors & Treatment Options
Now that you know the symptoms to watch 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 at risk for pericarditis If you’re recovering from a heart attack, have experienced trauma from an injury or accident, are experiencing kidney failure, have specific bacterial, viral, or fungal infections, recently had cardiac surgery, or have certain autoimmune disorders. If you have these risk factors or are experiencing symptoms, your doctor will likely perform tests, such as an electrocardiogram, X-ray, echocardiogram, or a CT scan.
If it’s determined you have pericarditis and it hasn’t progressed too far, anti-inflammatory medications are usually prescribed or possibly steroids in recurrent cases. In extreme cases, your doctor might recommend removing the built-up fluid from the pericardium or remove the pericardium completely.
One note of caution: Don’t try to diagnose chest pain or other heart attack-like symptoms yourself. If you’re experiencing chest pain, treat it as an emergency until you can be properly diagnosed.
Dr. Adesina is a board-certified Cardiology specialist at Kelsey-Seybold’s Berthelsen Main Campus, Clear Lake Clinic, and Pasadena Clinic. His clinical interests include preventive heart care, valvular disease, and cardiovascular imaging.