Are you feeling a sharp, stabbing chest pain that worsens when you breathe deeply, cough, or lie flat, but seems to ease when you sit up or lean forward? These are classic signs of pericarditis, a condition that occurs when the pericardium—the thin, fluid-filled sac surrounding your heart—becomes inflamed.
Pericarditis can affect anyone, regardless of age or medical history. While some cases are mild and resolve without treatment, others can rapidly progress and lead to serious health issues, such as cardiac tamponade or constrictive pericarditis, especially if not diagnosed early. Because the symptoms of pericarditis often mimic those of a heart attack, many people delay seeking help—putting themselves at risk of complications.
If you’ve recently had a viral infection, surgery, or trauma, or live with an autoimmune condition, your chances of developing pericarditis may be higher. Timely diagnosis and tailored treatment are key to avoiding long-term effects, especially for recurring or chronic cases.
In this article, we break down what is, its common and uncommon causes, how to recognize early warning signs, and why you should never ignore persistent chest pain. You’ll also learn when it’s time to seek urgent care and how to connect with some of the top cardiologists in Brooklyn who specialize in treating pericarditis with both compassion and expertise.
Don’t let your symptoms go unaddressed. Understanding pericarditis could save your life.
Types of Pericarditis
Pericarditis presents in various forms depending on how long it lasts, how often it occurs, and the root cause behind the inflammation. Understanding the different types is crucial to ensuring early diagnosis and proper treatment, especially since some forms can lead to serious complications if left unmanaged.
Acute Pericarditis
Acute pericarditis is the most common type and comes on suddenly, typically lasting for a few weeks—generally 4 to 6 weeks. Although it’s short-term, acute pericarditis can recur in some individuals. The symptoms, such as sharp chest pain that worsens with breathing or lying down, often mimic a heart attack, which is why immediate evaluation is essential. It’s often caused by viral infections but may also result from autoimmune diseases, trauma, or other medical conditions.
Chronic Pericarditis
When the inflammation of the pericardium persists for longer than six months, it’s classified as chronic pericarditis. This condition develops slowly and tends to cause persistent symptoms such as fatigue, difficulty breathing, dry cough, and sharp chest pain. Unlike acute pericarditis, chronic pericarditis may involve ongoing damage to the heart’s protective lining, leading to complications if not closely monitored and managed by a healthcare provider.
Constrictive Pericarditis
Constrictive pericarditis is a serious and often progressive condition in which the pericardium becomes thickened and scarred, restricting the heart’s natural movement. This rigid pericardial layer prevents the heart from expanding fully, impairing its ability to pump blood effectively. Common signs include swelling in the legs or abdomen, shortness of breath (especially during exertion), and fatigue. This condition typically results from repeated episodes of pericarditis over time and may require surgical intervention (pericardiectomy) in advanced cases.
Uremic Pericarditis
Uremic pericarditis arises due to advanced kidney failure, especially when waste products accumulate in the bloodstream—a condition known as uremia. This buildup of toxins can irritate the pericardium, causing inflammation and discomfort. It is commonly observed in patients who are not receiving dialysis or whose kidney function has deteriorated significantly.
Recurrent Pericarditis
Recurrent pericarditis occurs when symptoms return after at least one symptom-free month following an initial episode. Affecting 15 to 50% of patients who’ve had acute pericarditis, this type may be triggered by autoimmune responses, insufficient initial treatment, or underlying infections. Proper follow-up and tailored long-term treatment plans are essential to prevent future flares.
Incessant Pericarditis
This form of pericarditis causes continuous symptoms that last for more than 6 weeks but less than 3 months, despite ongoing treatment. Incessant pericarditis sits between acute and chronic forms and often requires close medical supervision to determine if the condition will resolve or evolve into a more chronic stage.
Infectious Pericarditis
As the name implies, infectious pericarditis is triggered by an infection—typically viral, but sometimes bacterial, fungal, or even parasitic. The body’s immune response to these infections can lead to significant pericardial inflammation. Viral pericarditis is the most frequent cause, but bacterial pericarditis, especially when caused by tuberculosis, can be more severe and require urgent treatment.
Idiopathic Pericarditis
Idiopathic pericarditis is diagnosed when doctors cannot identify a clear cause of the inflammation. Despite its name, idiopathic pericarditis is most often presumed to have a viral origin. While the symptoms may mirror other types, the treatment usually involves anti-inflammatory medications and close monitoring.
Traumatic Pericarditis
This type of pericarditis develops after physical trauma to the chest, such as from a car accident, fall, or even certain medical procedures involving the heart. Known as post-traumatic pericarditis, symptoms might not appear immediately and can take days or weeks to manifest. It’s important to notify your doctor of any recent injuries if symptoms of pericarditis begin.
Malignant Pericarditis
Malignant pericarditis occurs when cancer or cancer treatment affects the pericardium. This can happen either because a tumor grows near the heart or because cancer cells metastasize and cause inflammation. It’s more common in cancers such as lung, breast, and lymphoma. This form can be particularly serious, often requiring multidisciplinary care.
By understanding the types of pericarditis and their characteristics, individuals and healthcare providers can work together to develop effective treatment strategies. Early diagnosis and appropriate intervention are key to preventing complications such as pericardial effusion or cardiac tamponade, particularly in more severe forms like constrictive or malignant pericarditis.
Causes of Pericarditis: More Than Just a Viral Issue
Although the exact cause of pericarditis often remains unclear, especially in isolated cases, research and clinical experience suggest that many factors can trigger the inflammation of the pericardium. In fact, it’s believed that in a large percentage of cases, a mild or undetectable viral infection might be responsible—especially when no obvious underlying illness is found.
However, not all pericarditis cases are idiopathic. Some are directly linked to specific infections, diseases, medical conditions, or even post-surgical complications. Here’s a more detailed look into the recognized causes of pericarditis, categorized by origin:
Infectious Causes
Viral Infections: These are the most commonly suspected culprits. Even everyday viruses like the influenza virus, enteroviruses, herpes simplex, or glandular fever (EBV) can trigger pericarditis. In some cases, HIV or hepatitis C may also play a role.
Bacterial Infections: Though rare in developed countries, tuberculosis (TB) remains a serious cause of bacterial pericarditis globally, especially in immunocompromised individuals.
Fungal and Parasitic Infections: These are uncommon but can lead to chronic pericarditis in patients with weakened immune systems, particularly those undergoing long-term steroid use or chemotherapy.
Autoimmune and Inflammatory Conditions
Pericarditis can be a manifestation of systemic autoimmune diseases such as:
Systemic Lupus Erythematosus (SLE)
Rheumatoid Arthritis
Scleroderma
In these cases, the immune system mistakenly targets the pericardium, leading to ongoing inflammation.
Physical Injury and Trauma
Traumatic pericarditis may follow blunt chest trauma, such as that experienced in car accidents or severe sports injuries. It can also occur after invasive cardiac procedures.
Kidney and Metabolic Disorders
Uremic pericarditis is caused by the buildup of toxins in the blood due to advanced kidney failure. This form is more common in patients not yet on dialysis or those with poorly controlled kidney disease.
Cancer and Tumors
Malignant pericarditis arises when cancer spreads to the pericardium. This is particularly seen in lung cancer, breast cancer, and lymphomas. Tumor-related inflammation or direct invasion of the pericardium can lead to fluid accumulation and pain.
Genetic Disorders
Rare genetic syndromes like Familial Mediterranean Fever (FMF) can result in recurrent episodes of pericarditis, especially in populations with a higher prevalence of this condition.
Medications and Immune Response
Some immunosuppressive drugs, although rarely, may induce pericarditis as a side effect. Additionally, certain vaccines or immune modulators have been loosely associated with transient pericardial inflammation, though these cases are still being studied.
Increased Risk After Cardiac Events or Procedures
In some people, pericarditis doesn’t arise from infection or disease but as a delayed reaction to cardiac trauma. This includes:
After a heart attack (often called Dressler’s Syndrome)
Following open-heart surgery
After radiation therapy for chest cancers
Post catheter-based procedures, such as cardiac ablation or angioplasty
In these cases, the body sometimes mounts an exaggerated immune response, resulting in pericardial inflammation weeks after the original event. Because the onset is delayed, patients often overlook the connection and delay seeking treatment.
If you’ve had a recent cardiac procedure or trauma, and you experience chest pain, shortness of breath, or persistent fatigue, it’s essential to discuss the possibility of pericarditis with your cardiologist or surgeon. Early diagnosis and management are key to preventing chronic complications.
Recognizing the Symptoms of Pericarditis
Pericarditis symptoms can vary widely in severity and duration, depending on the type and underlying cause of the inflammation. For some individuals, the condition develops gradually and may be mistaken for fatigue, anxiety, or indigestion. For others, it can come on suddenly with intense discomfort that mimics a heart attack. Knowing how to identify the signs early can be key to getting prompt treatment and avoiding serious complications.
Common Symptoms
The hallmark symptom of pericarditis is chest pain. Unlike typical cardiac chest pain, the pain from pericarditis is often described as:
Sharp or stabbing, rather than squeezing or pressure-like.
Located behind the breastbone (sternum), sometimes radiating to the neck, shoulders, or upper back.
Worsened by lying flat, deep breathing, coughing, or swallowing.
Relieved by sitting up or leaning forward, a posture that takes pressure off the inflamed pericardium.
In addition to chest pain, other common symptoms include:
Shortness of breath, especially when lying down or with minimal exertion.
A dry, persistent cough without signs of upper respiratory infection.
Heart palpitations, or the sensation of a racing, pounding, or irregular heartbeat.
Low-grade fever and general malaise.
Fatigue, often unexplained and lasting throughout the day.
Anxiety or a sense of doom, which can occur when pain mimics a cardiac event.
Advanced or Severe Cases
In more severe forms of pericarditis—such as constrictive pericarditis or pericardial effusion—fluid can accumulate around the heart, limiting its ability to pump efficiently. In these cases, additional symptoms may develop, including:
Swelling in the lower extremities (legs, feet, or ankles), due to poor circulation.
Abdominal bloating or discomfort from fluid retention.
Dizziness or fainting, which may indicate restricted blood flow or cardiac tamponade, a life-threatening emergency.
Low blood pressure, especially when standing up, caused by impaired cardiac output.
When to Seek Medical Attention
If you’re experiencing any chest pain, especially if it’s sharp or changes with position or breathing, it’s important to seek medical advice—even if you suspect anxiety or muscle strain. Mild pericarditis can often resolve with rest and anti-inflammatory medication, but delayed treatment may lead to chronic or recurrent pericarditis, or more dangerous outcomes like heart failure or tamponade.
Call your doctor immediately if you notice symptoms of pericarditis. If the pain is severe, sudden, or accompanied by shortness of breath, dizziness, or fainting, call 911 or go to the emergency room immediately.
If you need help with pericarditis, visit our cardiology clinic in Brooklyn to get professional medical help. Call us to book your appointment now!!!
The Cardiologists at Doral Health & Wellness consistently have outstanding patient satisfaction ratings. The professionals at Heart Specialist Brooklyn are able to greatly improve their patient’s health and quality of life because of their vast training and experience. New Yorkers can get the greatest medical, surgical, and cardiovascular care at Doral Health & Wellness Brooklyn. Visit us at 1797 Pitkin Avenue, Brooklyn, NY 11212. You can reach us at +1(347) 384-5690 to schedule a consultation.
