Signs and Symptoms of Pericarditis

The most common symptom of pericarditis is chest pain. The pain is predominantly felt below the breastbone (sternum) and/or below the ribs on the left side of the chest and, occasionally, in the upper back or neck.

Breathing causes the lungs and heart to move in the chest and rub against the irritated pericardium, worsening the pain. Pain may worsen when patients lie down and may improve when they sit up and lean forward. Changes in position can increase or decrease pressure on and irritation of the inflamed pericardium.

Several things that cause pericarditis also cause fluid to accumulate between the pericardium and the heart (pericardial effusion). If enough fluid builds up quickly in this space, it can "compress" the heart's chambers. Through some fairly complex mechanisms, this sometimes leads to shortness of breath (dyspnea). The development of dyspnea is a matter of concern because it may indicate that the amount of fluid is reaching a critical point and requires urgent medical treatment.

While pericarditis usually is not life threatening, other life-threatening conditions may cause chest pain, including heart attack (myocardial infarction), dissection of the aorta ("tearing" of the body's main artery that runs through the chest and abdomen), blood clot lodged in the lung (pulmonary embolus), a collapsed lung, and perforation or rupture of parts of the digestive tract (e.g., esophagus, stomach). It is critical for anyone who experiences chest pain to seek immediate medical attention to determine the cause and receive prompt, appropriate treatment.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 01 Jul 2000

Last Modified: 29 Sep 2015