Overview
Sharp pain in your chest and back of the shoulders that feel better when you sit up and lean forward, and chest pain with breathing are two major clues that you may have pericarditis and not a heart attack. Your healthcare provider will talk to you about your symptoms and medical history (such as whether you’ve recently been sick) and review your history of heart conditions, surgery and other health problems that could put you at a higher risk of pericarditis.
Your provider will listen to your heart. The rubbing of your pericardium’s inflamed lining causes a rubbing or creaking sound called the “pericardial rub.” They’ll be able to hear it best when you lean forward, hold your breath and breathe out. Depending on how bad the inflammation is, your provider may also hear crackles in your lungs, which are signs of fluid in the space around your lungs or extra fluid in your pericardium.
What tests will be done to diagnose pericarditis?
Healthcare providers use a variety of ways to check for pericarditis and any complications, such as pericardial effusion or constrictive pericarditis. You may need one or more tests, such as:
- Chest X-ray to see the size of your heart and any fluid in your lungs.
- Electrocardiogram (ECG or EKG) to look for changes in your heart rhythm. In about half of all people with pericarditis, providers see some characteristic changes to a normal heart rhythm. Some people don’t have any changes. If they do, they may be temporary.
- Echocardiogram (echo) to see how well your heart is working and check for fluid (a pericardial effusion) around your heart. An echo will show the classic signs of constrictive pericarditis, including a stiff or thick pericardium that constricts your heart’s normal movement.
- Cardiac MRI to check for extra fluid in your pericardium, pericardial inflammation or thickening, or compression of your heart. Your provider will give you a contrast agent called gadolinium during this highly specialized test.
- CT scan to look for calcium in the pericardium, fluid, inflammation, tumors and disease of the areas around your heart. Your provider uses iodine dye during the test to get more information about the inflammation. This is an important test for patients who may need surgery for constrictive pericarditis.
- Cardiac catheterization to get information about the filling pressures in your heart. This test can confirm a diagnosis of constrictive pericarditis.
- Blood tests can help your provider make sure you’re not having a heart attack, see how well your heart is working, test the fluid in the pericardium and help find the cause of pericarditis. If you have pericarditis, it is common for your sedimentation rate (ESR) and ultra-sensitive C reactive protein levels (markers of inflammation) to be higher than normal. You may need other tests to check for autoimmune diseases like lupus and rheumatoid arthritis.
Symptoms
When to see a doctor
Complications
- High blood pressure.
- Diabetes.
- Heart failure.
- Some types of heart valve disease.
Prevention
- Control high blood pressure, high cholesterol and diabetes.
- Don't smoke or use tobacco.
- Eat a diet that's low in salt and saturated fat.
- Exercise at least 30 minutes a day on most days of the week unless your health care team says not to.
- Get good sleep. Adults should aim for 7 to 9 hours daily.
- Maintain a healthy weight.
- Reduce and manage stress.
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