Medically reviewed by Dr Nabila Laskar, Consultant Cardiologist (GMC 7040901). Pericarditis is inflammation of the pericardium, the thin sac surrounding the heart. It causes a characteristic sharp chest pain and is usually treatable, but it must be distinguished from a heart attack.
Sharp, stabbing chest pain that worsens on lying flat, breathing in or coughing, and eases on sitting forward. Fever, fatigue and breathlessness may accompany it. Any severe or unexplained chest pain requires urgent assessment — see /conditions/chest-pain.
Most commonly viral infection. Other causes include autoimmune conditions, recent cardiac surgery or heart attack, kidney failure, and certain medications. In many cases no specific cause is identified.
An ECG often shows a distinctive pattern, blood tests measure inflammatory markers and cardiac enzymes, and an echocardiogram checks for fluid around the heart. Further imaging is used where the diagnosis is uncertain.
Treatment is prescribed and monitored by a doctor and typically involves anti-inflammatory medication with a tapering course, plus rest from strenuous exercise until inflammatory markers normalise. Most people recover fully, though a minority experience recurrence and need longer follow-up.
Most acute episodes settle within a few weeks with appropriate treatment. A minority develop recurrent or persistent pericarditis and need longer courses of medication under cardiology supervision.
Most cases are self-limiting. It becomes serious if a significant volume of fluid accumulates around the heart and restricts filling, which is why an echocardiogram forms part of the assessment.
Strenuous exercise should be avoided until symptoms have resolved and inflammatory markers have normalised. Your cardiologist will advise when it is safe to return, which for athletes may be several months.
No, but the two can feel similar and only assessment with an ECG and blood tests can reliably distinguish them. Treat sudden severe chest pain as an emergency and call 999.