Acute Pericarditis: Symptoms Causes and Diagnosis

Acute pericarditis is a condition characterized by inflammation of the pericardium, the double-walled sac that surrounds the heart. The pericardium consists of two layers — the outer fibrous layer and the inner serous layer. The serous pericardium is further divided into the parietal layer, which lines the inside of the fibrous pericardium, and the visceral layer, which covers the surface of the heart muscle. Between these layers lies the pericardial cavity, which normally contains a small amount of fluid to reduce friction as the heart beats.

Understanding the Causes

Acute pericarditis can be triggered by a range of factors including viral or bacterial infections, physical trauma, autoimmune disorders, or exposure to certain chemicals. These irritants lead to an inflammatory response within the pericardial cavity, often resulting in fluid accumulation and increased pressure around the heart. This inflammation is what causes the discomfort and other symptoms associated with the condition.

Common Symptoms

Patients with acute pericarditis may experience a variety of systemic symptoms such as chills, fever, fatigue, and general weakness. One of the most notable signs is chest pain, which typically worsens during deep breaths, coughing, or when lying on the left side. In more severe cases, the inflamed pericardium may press against nearby structures like the trachea, bronchi, and lungs, leading to difficulty breathing or swallowing.

Key Diagnostic Signs

During a physical examination, a doctor may detect a characteristic sound known as a pericardial friction rub — a scratchy or grating noise that occurs when the inflamed layers of the pericardium rub against each other. This sound is a key indicator of pericarditis and helps differentiate it from other cardiac conditions.

Diagnostic Tools and Confirmation

To confirm a diagnosis of acute pericarditis, healthcare providers rely on a combination of tests. An electrocardiogram (ECG) often shows specific changes that suggest pericardial inflammation. Echocardiography provides detailed images of the heart and can reveal any fluid buildup in the pericardial space. Additionally, chest X-rays may be used to rule out other potential causes of chest pain and assess the overall condition of the heart and surrounding structures.