While some types of acute pericarditis can begin with few or no symptoms, it most often causes the following symptoms:
- Chest pain that usually runs to the left shoulder and sometimes down the left arm. The pain may be like that of a heart attack except that it gets worse when lying down, swallowing food, coughing or breathing deeply.
- Rising blood pressure if the fluid or blood that collects between the layers of the pericardium interferes with its ability to pump blood. If the pressure gets too high, a life-threatening complication, cardiac tamponade, may develop.
There may be no symptoms at the beginning of acute pericarditis that develops due to tuberculosis. It may produce fever and symptoms of heart failure.
When acute pericarditis is caused by virus infection, it is usually painful, but goes away in a short time without lasting effects.
If acute pericarditis develops a day or two after a heart attack, the focus is on the larger issue of the heart attack. If acute pericarditis develops in the period 10 days to two months after a heart attack, symptoms include:
- Fluid collecting in the space between the two layers of membrane that cover the lungs (the pleura)
- Fluid collecting in the space between the two layers of the pericardium,
- Inflammation (tenderness and swelling) of the membranes that cover the lungs (the pleura)
- Joint pain
Causes and Risk Factors
Usually acute pericarditis develops as a result of an infection or other condition that irritates the pericardium.
Infections that cause pericarditis are usually due to viruses but may be caused by bacteria, parasites (including protozoa) or fungi. AIDS, because it impairs the immune system and makes the body vulnerable to infections, can be associated with pericarditis.
Conditions that can irritate the pericardium and lead to acute pericarditis include:
- Heart attack. Acute pericarditis can develop in the first day or two or after 10 days to two months after a heart attack.
- Blood leaking from an aortic aneurysm (a bulge in the wall of the aorta)
- Cancer (such as leukemia or Kaposi's sarcoma)
- Certain drugs, including anticoagulants, penicillin, procainamide (an antiarrhythmic drug), phenytoin (an anticonvulsant) and phenylbutazone (a nonsteroidal anti-inflammatory drug)
- Heart surgery
- Kidney failure
- Radiation therapy
- Rheumatic fever
- Rheumatoid arthritis