Heart sac inflammation

Overview

Inflammation of the heart sac (pericarditis) can be caused by viruses and bacteria or as a complication of another disease. It often occurs at the same time as a cold, flu or fever. The main symptoms are a shooting pain behind the sternum when you breathe in or out and a feeling of weakness. The condition should be checked by a doctor, and the body should be rested.

Symptoms

Main symptoms

• Shooting pain in the chest, behind the sternum
  • Linked to breathing (different from the pain of a heart attack!)
  • Typically worsens when you draw a deep breath, cough and lie down
  • Improves if the upper body is bent forward
• Often occurs at the same time as a cold, flu or fever
• Reduced physical performance, weakness
• Usually heals within 1 to 2 weeks (it often goes unnoticed). After-effects are rare

Other symptoms

• Shortness of breath
• Racing heart
• Congested neck veins, swollen legs

Complication

• Pericardial tamponade: collection of fluid in the heart sac and impaired heart function
  • Acute emergency

Causes and treatment

Causes

• Viral infection (most cases of heart sac inflammation are caused by viruses)
  • Flu viruses, parvovirus B19 (causes fifth disease)
  • Cytomegalovirus (CMV) or HIV
• Bacterial infection (more rarely)
  • Tuberculosis bacteria
  • Bacteria entering the bloodstream as a result of blood poisoning
• As complication caused by other diseases
  • Rheumatic fever, rheumatoid arthritis
  • After a heart attack or heart surgery
  • Acute kidney failure
  • Tumours (in particular lung, breast, oesophageal cancer and leukaemia)
  • Radiation therapy

Further treatment by your doctor / in hospital

Possible tests

• Listening to the heart (stethoscope)
• Electrocardiogram (ECG)
• Blood test (signs of inflammation and heart enzymes)
• Heart ultrasound
• X-ray of chest cavity

Possible therapies

• Treatment of symptoms (e.g. painkillers, anti-inflammatories)
• Possibly antibiotics or cortisone
• Cannulation to relieve pressure on the heart (only for pericardial tamponade)
• Treatment of the underlying disease

What can I do myself?

• Rest your body, bed rest

When to see a doctor?

• Pain behind the sternum
• Shortness of breath, racing heart and falling blood pressure
• Congested neck veins
• Severe pain in the upper abdomen

Synonyms

heart sac inflammation, pericarditis, perimyocarditis, inflammation of the heart sac