Pericarditis history and symptoms


 * Associate Editor-In-Chief:

Overview
Patients with pericarditis commonly present with chest pain that changes with position, cough, fever, breathlessness and fatigue.

Disorders With Similar Symptoms
Pericarditis can be misdiagnosed as myocardial infarction, pneumonia, or pulmonary embolism and vice versa.

For a full discussion of how to differentiate pericarditis from other causes of chest pain click here

For a full discussion of the differential diagnosis of chest pain click here

For an expert algorithm that aids in the diagnosis of the cause of chest pain click here

Common Symptoms

 * Chest pain is the most common symptom. It often radiates to the back and is relieved by sitting up and leaning forward and is worsened by lying down.  Causes of pain include inflammation of the pericardium, phrenic nerves, and the nearby pleura.  The pain is often initially sharp in nature, but it can be described as sticking, dull, aching, or pressure-like.  Deep inspiration and cough can increase the pain so that the patient may sit upright for relief.
 * Cough can be either dry or productive
 * Fever
 * Fatigue
 * Anxiety
 * Breathlessness

Less Common Symptoms

 * Pain along the trapezius ridge(s), when present is very characteristic of pericarditis. The pain of myocardial infarction tends to involve the anterior precordium with radiation to the left arm.
 * Hiccup (rarely)
 * Odynophagia with or without dysphagia
 * Faintness and dizziness (uncommon unless cardiac tamponade is present)

Rapidity of Symptom Onset
The rapidity of onset of symptoms may provide insight into the underlying etiology of pericarditis. For example, pericarditis associated with both uremia and tuberculosis develop more slowly and can be undetectable until presenting as a fever of unknown origin. On the other hand, both bacterial and viral pericarditis develop rapidly and can present as rapidly increasing pain over several hours.