Chest Pain In Acute Pericarditis: Understanding The Causes

Acute pericarditis is a condition characterized by inflammation of the pericardium, the thin sac that surrounds the heart. One of the most prominent symptoms associated with this condition is chest pain, which can radiate to the chest area, back, shoulders, and in some cases, even the upper abdomen. This pain is often more intense and noticeable in cases of non-specific pericarditis and viral pericarditis. The discomfort is typically influenced by body position and respiratory movements, and there are three primary reasons behind this symptom, which may often overlap:

1. Pleuritic Chest Pain Due To Pleurisy

During acute pericarditis, pleurisy (inflammation of the pleura) often occurs simultaneously. This can cause sharp, intense pain that worsens with breathing, changes in posture, or even coughing. The pain is typically described as a stabbing sensation, especially during deep inhalation.

2. Retrosternal Pain Similar To Angina

What Causes This Type Of Pain?

Another common type of discomfort is retrosternal pressure-like chest pain, which closely resembles the pain experienced during a heart attack. This similarity can make it difficult to distinguish between cardiac ischemia and pericardial pain. The underlying cause is the irritation of sensory nerve fibers located beneath the outer layer of the coronary arteries, known as afferent nerve fibers, due to inflammatory processes.

3. Pain Associated With Cardiac Contraction

A Less Common But Noteworthy Symptom

In rare cases, patients may experience pain that occurs in sync with each heartbeat. This type of pain is directly related to the mechanical activity of the heart and is a distinctive feature of certain pericardial conditions. While less common, it is an important clinical sign that healthcare providers should recognize.