Pericarditis Typical Clinical Manifestations And Symptoms

Pericarditis is a condition that affects the pericardium, the thin sac-like membrane surrounding the heart. The clinical presentation of pericarditis can vary depending on the underlying cause and whether it is classified as acute or chronic. Acute pericarditis can be further divided into infectious and non-infectious types, while chronic pericarditis typically develops more gradually and may persist over a longer period.

Acute Pericarditis Symptoms

Patients with acute pericarditis often experience sudden onset symptoms. Those with infectious causes, such as bacterial or viral infections, may exhibit signs of systemic infection, including fever, chills, and general malaise. In cases of tuberculosis or purulent pericarditis, the fever may be persistent and high-grade.

Common symptoms of acute pericarditis include:

Chest pain: Sharp, stabbing pain that may radiate to the left shoulder or back. The discomfort typically worsens with deep breaths, lying down, or coughing, and may improve when sitting up or leaning forward.
Shortness of breath: Especially noticeable when lying flat, due to pressure from fluid accumulation around the heart.
Heart palpitations: Some patients may feel irregular or rapid heartbeats.
Hypotension: Low blood pressure can occur, particularly in cases where there is significant fluid buildup in the pericardial space, leading to cardiac tamponade.

Non-Infectious Causes Of Acute Pericarditis

Non-infectious forms of acute pericarditis can be associated with conditions such as autoimmune diseases (e.g., lupus or rheumatoid arthritis), malignancies, radiation therapy to the chest, or following heart surgery. These cases may present with similar symptoms, though fever may be less prominent.

Chronic Pericarditis Signs And Complications

Chronic pericarditis usually manifests with more subtle, long-standing symptoms. It often mimics right-sided heart failure due to the gradual constriction or thickening of the pericardium, which restricts normal heart function.

Typical signs and symptoms of chronic pericarditis include:

Elevated venous pressure: This may lead to jugular venous distention, where the neck veins appear swollen or bulging.
Abdominal discomfort: Due to liver congestion and fluid accumulation, patients may experience bloating, early satiety, and indigestion.
Lower extremity edema: Swelling in the legs and ankles caused by fluid retention.
General fatigue: A persistent feeling of tiredness due to reduced cardiac output.

Recognizing these symptoms early and seeking medical attention is crucial for effective diagnosis and treatment of pericarditis, regardless of its type or duration.