Acute Pericarditis: Understanding Its Key Characteristics

Acute pericarditis is a condition marked by sudden inflammation of the pericardium, the sac-like membrane surrounding the heart. One of the most prominent symptoms is sharp, intense chest pain located behind the breastbone or in the front of the chest. This discomfort often occurs during the fibrinous exudative phase of the inflammation and can radiate to areas such as the neck, left shoulder, left arm, or even the upper abdomen.

What Makes the Pain Unique?

The chest pain associated with acute pericarditis is typically sharp in nature and closely related to respiratory movements. It tends to worsen with actions like coughing, deep breathing, changing body positions, or swallowing. Unlike the chest pain seen in heart attacks, this pain may improve when the patient sits up or leans forward.

Additional Symptoms and Complications

Some patients may experience complications such as pericardial effusion, which can lead to cardiac tamponade—a serious condition that impairs heart function. Symptoms may include shortness of breath, swelling in the legs or other parts of the body, and signs of heart failure. In cases of infectious pericarditis, fever is often present and may accompany chills or general malaise.

What to Listen For: Heart Sounds

During a physical examination, a healthcare provider may detect a pericardial friction rub using a stethoscope. This sound is often described as scratchy, grating, or high-pitched, and is best heard in the precordial region—specifically at the left sternal border between the third and fourth intercostal spaces.

Why Early Diagnosis Matters

Recognizing the distinct features of acute pericarditis is crucial for timely diagnosis and treatment. Because its symptoms can mimic those of other cardiac conditions, understanding its unique presentation—especially the nature of the pain and associated physical findings—can help guide appropriate medical evaluation and intervention.