When listening to the heart with a stethoscope, the health care provider can hear a sound called a pericardial rub. The heart sounds may be muffled or distant. There may be other signs of fluid in the pericardium (pericardial effusion).
The cause of pericarditis must be identified, if possible.
High doses of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are often given. These medicines will decrease your pain and reduce the swelling or inflammation in the sac around your heart.
A medicine called colchicine may be added, especially if pericarditis does not go away after 1 to 2 weeks or it comes back weeks or months later.
If the cause of pericarditis is an infection:
Antibiotics will be used for bacterial infections
Antifungal medications will be used for fungal pericarditis
Other medicines that may be used are:
Corticosteroids such as prednisone (in some patients)
"Water pills" (diuretics) to remove excess fluid
If the buildup of fluid makes the heart function poorly, treatment may include:
Draining the fluid from the sac. This procedure, called pericardiocentesis, may be done using an echocardiography-guided needle.
Cutting a small hole (window) in the pericardium (subxiphoid pericardiotomy) to allow the infected fluid to drain into the abdominal cavity
If the pericarditis is chronic, recurrent, or causes scarring or tightening of the tissue around the heart, cutting or removing part of the pericardium may be needed. This surgery is called a pericardiectomy.
Pericarditis can range from mild cases that get better on their own to life-threatening cases. The condition can be complicated by fluid buildup around the heart and poor heart function.
The outcome is good if the disorder is treated right away. Most people recover in 2 weeks to 3 months. However, pericarditis may come back. This is called recurrent, or chronic if symptoms or episodes continue.
Scarring and thickening of the sac-like covering and the heart muscle may occur in severe cases. This is called constrictive pericarditis, and it can cause long-term problems similar to those of heart failure.
Calling your health care provider
Call your health care provider if you have symptoms of pericarditis. This disorder is usually not life threatening, but it can be if not treated.
Many cases are not preventable.
LeWinter MM, Tischler MD. Pericardial diseases. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 75.
Michael A. Chen, MD, PhD, Assistant Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.