Cookies on the Bupa website

We use cookies to help us understand ease of use and relevance of content. This ensures that we can give you the best experience on our website. If you continue, we'll assume that you are happy to receive cookies for this purpose. Find out more about cookies

Continue

Navigation

Pericarditis

Your heart is surrounded and protected by a double-layered sac called the pericardium. If this becomes inflamed (swollen), the condition is known as pericarditis.

You can get pericarditis after a heart attack or sometimes on its own. Around five in 100 people who go to an accident and emergency department with chest pain (who aren’t having a heart attack) are diagnosed with pericarditis.

More men than women get pericarditis. People of all ages can get pericarditis but it’s more common in adults.

Pericarditis can get better without treatment but it can also come back. If pericarditis lasts longer than three months (and there isn't a known cause), it’s called chronic pericarditis.

Read more Close

Details

  • Symptoms Symptoms of pericarditis

    The main symptom of pericarditis is a sharp, constant pain in your chest. You may find this gets better if you sit and lean forwards. The pain may spread to your left shoulder and arm. It tends to get worse if you lie down, when you breathe in, swallow or cough. Other symptoms include:

    • a fever
    • a cough
    • breathlessness
    • feeling weak

    The symptoms of pericarditis are similar to those of a heart attack. You may need to have some tests to determine which condition you have. If you have any sudden chest pain, seek urgent medical attention.

    Bupa On Demand

    Want to talk to a Bupa consultant? We’ll aim to get you seen the next day. Prices from £250.

  • Diagnosis Diagnosis of pericarditis

    You may see a cardiologist in hospital – a doctor who specialises in identifying and treating conditions of the heart and blood vessels. They will ask about your symptoms and examine you. Your doctor may also ask about your medical history and if you have recently had symptoms of an infection, such as a cold or flu.

    Your doctor will listen to your heart with a stethoscope. He or she may be able to hear a ‘rubbing’ sound called pericardial rub, which is a sign of pericarditis.

    Other tests you may have include the following.

    • Blood tests. These can be used to check for signs of inflammation.
    • An electrocardiogram (ECG). This test measures the electrical activity of your heart to see how well it’s working. There are certain changes that your doctor can look for that might help in diagnosing pericarditis.
    • An echocardiogram will help your doctor to see if there is any fluid in between the two layers of your pericardium. An echocardiogram is an ultrasound scan of your heart. See our FAQs for more information.
    • A chest X-ray. If there is a large amount of fluid within your pericardium, the X-ray may show that your heart is enlarged.
    • A CT scan or MRI scan. If your pericardium is thickened because of a condition called constrictive pericarditis, it will show up in these scans. Constrictive pericarditis can be caused by a number of things.
    • Examination of pericardial fluid. Your doctor may drain fluid from your pericardium and test this for signs of infection or cancer cells.
  • Treatment Treatment of pericarditis

    Most people with pericarditis get better within days or weeks without any treatment. However, you may need treatment for the symptoms or to prevent complications.

    If possible, any underlying cause of pericarditis should be treated. For example, if your pericarditis was caused by a bacterial infection such as tuberculosis, your doctor will you prescribe a course of antibiotics.

    Your doctor may advise you to take over-the-counter painkillers or prescribe you non-steroidal anti-inflammatory drugs (NSAIDs) for the pain. They will also probably prescribe you a medicine called a proton pump inhibitor. This is because NSAIDs can cause side-effects that affect your stomach and proton pump inhibitors can reduce these. Your doctor may also prescribe you a medicine called colchicine to help with the pain.

    Your doctor may also prescribe you colchicine if you have reoccurring pericarditis (where your condition comes back after a period of time). This may keep your symptoms away for longer. Attacks of pericarditis may also be shorter with less severe symptoms.

    If your doctor prescribes you colchicine in the UK, it will be for off-label use. This means the medicine is being used to treat a condition that it hasn’t been licensed for. It isn’t listed in the patient information leaflet that comes with the medicine. A doctor can legally prescribe outside the licence if they believe the medicine will be effective for you.

    Some types of pericarditis can be treated with corticosteroid medicines but these don’t work for everybody. Ask your doctor if they are an option for you.

    Always ask your doctor for advice and read the patient information leaflet that comes with your medicine.

    Your doctor will advise you to rest and not do any strenuous activity for a few weeks to help reduce your symptoms.

  • Worried about your heart health?

    Get a picture of your current health and potential future health risks with a Bupa health assessment. Find out more today.

  • Causes Causes of pericarditis

    Pericarditis happens when there is inflammation of your pericardium. This may lead to a build-up of fluid and a thickening of your pericardium. In many people, it’s not known what causes it. But there are some things that are known to cause pericarditis, which include:

  • Complications Complications of pericarditis

    Pericarditis can lead to two complications called pericardial effusion and constrictive pericarditis. You’ll need further treatment if you develop either of these.

    Pericardial effusion

    Pericardial effusion is when fluid builds up between the two layers of your pericardium. If too much fluid builds up, it can prevent your heart from filling properly because of the increased pressure. This is known as cardiac tamponade.

    If you have pericardial effusion, you may need to have a procedure to drain the excess fluid and allow your heart to work well again. This is called pericardiocentesis or a pericardial tap.

    Constrictive pericarditis

    Constrictive pericarditis is a thickening and hardening of your pericardium. This may happen as a result of a long-term infection of your pericardium, sometimes because of tuberculosis. However, there may be no clear cause. The thickened pericardium stops your heart from filling properly between heartbeats. You may need to have an operation to remove part or all of your pericardium to help your heart to function as it should.

  • FAQs FAQs

    What does an echocardiogram involve?

    Answer

    An echocardiogram is an ultrasound scan of your heart. Ultrasound uses sound waves to produce an image of your heart on a monitor. This can help your cardiologist (a doctor who specialises in identifying and treating conditions of the heart and blood vessels) make a diagnosis of pericarditis.

    Explanation

    Having an echocardiogram isn’t painful and it usually takes between 30 and 40 minutes.

    You’ll be asked to remove your clothing from the waist up and to put on a gown that will be open at the front. You will lie on your left side on an examination bed. A sonographer (a person specially trained to do ultrasounds) will dim the lights to make the images easier to see.

    The sonographer will put some gel on your chest so that the ultrasound waves can be picked up better by the machine. They will place the ultrasound probe (similar to a large, smooth pen) onto your chest and move it around. This will get images of your heart from different angles.

    You’ll probably have an electrocardiogram (ECG) done at the same time. This will measure the electrical activity of your heart to see how well it’s working. You will have some electrode patches stuck to your chest for this test.

    If you have any questions about having an echocardiogram, ask your doctor.

    How long after a heart attack does it usually take for pericarditis to develop?

    Answer

    If your pericarditis was caused by a heart attack, it can begin as soon as two days afterwards. It may take longer than this and might not begin until months after you have a heart attack. However, it’s much less likely that you’ll develop pericarditis after a heart attack than it used to be. This is because there are more effective medicines to treat a heart attack.

    Explanation

    The treatment doctors give after a heart attack has reduced the number of people going on to develop pericarditis to fewer than one in 10. If you do get pericarditis soon after a heart attack, you may not need treatment for it. This is because the condition may go away on its own and rarely leads to complications.

    Another type of pericarditis that used to be more common is Dressler syndrome. This is pericarditis that begins between two and 10 weeks after a heart attack. It’s caused by your immune system reacting to the damaged heart tissue. However, medicines given after a heart attack have reduced this happening and Dressler syndrome is now rare.

    What is the difference between pericarditis and myocarditis?

    Answer

    Pericarditis is inflammation of the sac surrounding your heart (the pericardium) and myocarditis is inflammation of the heart muscle itself. Each condition has slightly different symptoms. Often, pericarditis and myocarditis occur together because the inflammatory process also involves the outer layer of heart muscle below the pericardium.

    Explanation

    Pericarditis is commonly caused by a virus that infects your pericardium surrounding your heart. However, often no cause can be found. One symptom of pericarditis is sharp pain in your chest, which gets worse if you lie down but improves if you sit leaning forwards. Other symptoms may include a fever or breathlessness. Your cardiologist may give you non-steroidal anti-inflammatory drugs (NSAIDs) to take to ease the pain. Sometimes, your doctor may give you a medicine called colchicine, or corticosteroids.

    Myocarditis is also often caused by a virus or bacterium that has infected the muscle of your heart. Symptoms include chest pain, breathlessness and palpitations (an unpleasant awareness of your heartbeat, often described as a thumping in your chest). Unlike pericarditis, you might not need any medicine as the condition often goes away on its own. However, your doctor may advise you to take a break from strenuous exercise for several months after you recover to help prevent the condition coming back.

  • Resources Resources

    Further information

    Sources

    • Acute pericarditis. Medscape. www.emedicine.medscape.com, published 3 June 2013
    • Imaging in constrictive pericarditis. Medscape. www.emedicine.medscape.com, published 12 September 2013
    • Pericarditis. The Merck Manuals. www.merckmanuals.com, published May 2014
    • Acute pericarditis. PatientPlus. www.patient.co.uk/patientplus.asp, reviewed 20 November 2013
    • What is pericarditis? National Heart Lung and Blood Institute. www.nhlbi.nih.gov, published 26 September 2012
    • Needle pericardiocentesis. Medscape. www.patient.co.uk/patientplus.asp, published 16 July 2010
    • Constrictive pericarditis. Medscape. www.emedicine.medscape.com, published 14 September 2012
    • Chest pain. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published March 2011
    • Lilly LS. Treatment of acute and recurrent idiopathic pericarditis. Circulation 2013; 127(16):1723–26. doi:10.1161/CIRCULATIONAHA.111.066365
    • Lotrionte M, Biondi-Zoccai G, Imazio M, et al. International collaborative systematic review of controlled clinical trials on pharmacologic treatments for acute pericarditis and its recurrences. Am Heart J; 160(4):662–70. doi:10.1016/j.ahj.2010.06.015
    • Imazio M, Belli R, Brucato A, et al. Efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis (CORP-2): a multicentre, double-blind, placebo-controlled, randomised trial. Lancet 2014; 383(9936):2232–37. doi: 10.1016/S0140-6736(13)62709-9
    • Maisch B, Seferović PM, Ristić AD, et al. Guidelines on the diagnosis and management of pericardial diseases. Eur Heart J 2004; 25(7):587-610. doi:10.1016/j.ehj.2004.02.002.
    • Imazio M, Brucato A, Forno D. Efficacy and safety of colchicine for pericarditis prevention. Systematic review and meta-analysis. Heart 2012; 98(14):1078–82. doi:10.1136/heartjnl-2011-301306
    • Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 9 July 2014
    • Transthoracic echocardiography. British Society of Echocardiography. www.bsecho.org, accessed 9 July 2014
    • Acute coronary syndromes (ACS). The Merck Manuals. www.merckmanuals.com, published May 2013
    • Myocarditis. Medscape. www.emedicine.medscape.com, published 23 April 2014
    • Myocarditis. PatientPlus. www.patient.co.uk/patientplus.asp, reviewed 11 February 2014
  • Has our information helped you? Tell us what you think about this page

    We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.

    Let us know what you think using our short feedback form
    Ask us a question
  • Related information Related information

  • Author information Author information

    Reviewed by Rachael Mayfield-Blake, Bupa Health Information Team, September 2014.

    Let us know what you think using our short feedback form
    Ask us a question

About our health information

At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.

  • Information Standard

    We are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.
    Information standard logo
  • HONcode

    This site complies with the HONcode standard for trustworthy health information: verify here.

    This website is certified by Health On the Net Foundation. Click to verify.

What our readers say about us

But don't just take our word for it; here's some feedback from our readers.

Simple and easy to use website - not alarming, just helpful.

It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.

Good information, easy to find, trustworthy.

Meet the team

Image of Andrew Byron

Andrew Byron
Head of health content and clinical engagement




  • Dylan Merkett – Lead Editor – UK Customer
  • Nick Ridgman – Lead Editor – UK Health and Care Services
  • Natalie Heaton – Specialist Editor – User Experience
  • Pippa Coulter – Specialist Editor – Content Library
  • Alice Rossiter – Specialist Editor – Insights
  • Laura Blanks – Specialist Editor – Quality
  • Michelle Harrison – Editorial Assistant

Our core principles

All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.

An image showing or editorial principals

                  Click to open full-size image

The ‘3Rs’ encompass everything we believe good health information should be. From tweets to in-depth reports, videos to quizzes, every piece of content we produce has these as its foundation.

Readable

In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.

Reliable

We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.

Relevant

We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.

Our accreditation

Here are just a few of the ways in which the quality of our information has been recognised.

  • The Information Standard certification scheme

    You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.

    It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.

    Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.

  • British Medical Association (BMA) patient information awards

    We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.

Contact us

If you have any feedback on our health information, we would love to hear from you. Please contact us via email: healthinfo@bupa.com. Or you can write to us:

Health Content Team
Bupa House
15-19 Bloomsbury Way
London
WC1A 2BA

Find out more Close

Legal disclaimer

This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition.

The information contained on this page and in any third party websites referred to on this page is not intended nor implied to be a substitute for professional medical advice nor is it intended to be for medical diagnosis or treatment. Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites. We do not accept advertising on this page.

For more details on how we produce our content and its sources, visit the 'About our health information' section.

ˆ We may record or monitor our calls.