About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Pericarditis: Signs, Symptoms, and Clinical Presentation
Introduction
Pericarditis is an inflammation of the pericardium, the thin sac surrounding the heart. It can be caused by infections, autoimmune diseases, or other medical conditions. Timely diagnosis is crucial to prevent complications such as pericardial effusion and cardiac tamponade.
Key Signs and Symptoms
1. Chest Pain
- The most common symptom.
- Typically sharp and pleuritic (worsens with inspiration or coughing).
- Pain improves when sitting up and leaning forward but worsens when lying down.
2. Pericardial Friction Rub
- A scratchy or grating heart sound heard during auscultation.
- Best heard at the left lower sternal border when the patient leans forward.
3. Fever
- More common in infectious or autoimmune causes of pericarditis.
4. Shortness of Breath (Dyspnea)
- May occur if pericardial effusion develops and restricts heart function.
5. ECG Changes
- Widespread ST-segment elevation.
- PR-segment depression in early stages.
6. Signs of Pericardial Effusion or Tamponade (Severe Cases)
- Pulsus paradoxus (drop in blood pressure during inspiration).
- Hypotension, jugular vein distension, and muffled heart sounds (Beck’s triad in tamponade).
Differential Diagnosis
Since pericarditis shares symptoms with several cardiac and non-cardiac conditions, it is crucial to differentiate it from: - Myocardial infarction (MI) (usually has localized ST elevation and lacks PR depression). - Pulmonary embolism (causes pleuritic chest pain but different ECG findings). - Pneumonia or pleuritis (may also cause pleuritic pain, but without typical pericardial features).
Conclusion
Prompt recognition of pericarditis is crucial for effective treatment. If you experience persistent chest pain, especially if it improves when leaning forward, consult a doctor immediately.
Source recommendations
1. 2023 ESC Guidelines on Pericardial Diseases
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Pericardial-Diseases-Guidelines-on-the-Diagnosis-and-Management-of
- https://pubmed.ncbi.nlm.nih.gov/26320112/
- https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/tip-and-tricks-for-acute-pericarditis
- https://www.jacc.org/doi/10.1016/j.jacc.2019.11.021
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Guidelines-derivative-products/Pocket-Guidelines/Pericardial-Diseases
2. AHA/ACC/ASE 2015 Guidelines for Pericardial Disease
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001029
- https://www.sciencedirect.com/science/article/pii/S0735109721057946
- https://www.ahajournals.org/doi/10.1161/cir.0000000000001030
- https://www.jacc.org/doi/10.1016/j.jacc.2023.04.003
- https://www.sciencedirect.com/science/article/abs/pii/S0894731713005336
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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