Realistic Human Heart Image Individuals who see their symptoms return after a four or six-week period are usually diagnosed with recurrent pericarditis. While this condition shares similarities with the acute variety, it can produce new challenges for affected patients nationwide. That’s why Myocarditis Foundation is committed to raising awareness about recurrent pericarditis, as well as supporting the medical community’s efforts to find a cure. Learn about recurrent pericarditis symptoms, diagnosis, and treatment options.

What Causes Recurrent Pericarditis?

Approximately 20 to 30% of people with acute pericarditis develop returning symptoms, an average of 40,000 people in the United States. People of all ages experience recurrent pericarditis, and many cite that it lasts longer with subsequent instances.  While doctors typically cannot pinpoint the exact cause of recurrent pericarditis, they believe several factors can lead to the condition, including:

  • Auto-inflammation from internal body issues
  • Complications resulting from a heart attack or cardiac surgery
  • Immune system dysfunction
  • Kidney failure and other metabolic problems
  • Metastatic cancer
  • Tuberculosis and other bacterial, fungal, and parasitic infections
  • Types of medications that affect the pericardium
  • Viral illnesses

What Are the Symptoms?

Most people with recurrent pericarditis develop the same symptoms from their initial experience with pericarditis, but with less intensity. The primary indicator of this condition is a piercing pain in the chest that exacerbates with coughing, lying down, and deep breathing. This pain often progresses to the neck, shoulders, or upper back, creating discomfort in multiple areas throughout the body. You may also encounter numerous other symptoms, including:

  • Pericardial effusion, or a build-up of fluid between the heart and pericardium
  • Low-grade fever
  • Coughing
  • Heart palpitations
  • Shortness of breath
  • Swollen legs, feet, or abdomen
  • Tiredness
  • Depression or anxiety

Diagnosis and Treatment

If your doctor thinks you have pericarditis, they will first review your health history and conduct a physical examination. This step helps them measure your risk and rule out other conditions. Often, doctors can tell if patients have pericarditis by hearing rubbing sounds when they listen to their hearts. After the examination, the doctor will perform tests to understand how the condition affects you. While no specific guidelines for diagnosing pericarditis exist in the United States, there are several common tests doctors use, including:

  • Blood work: A full blood count shows an increase in white blood cells and details biomarkers of inflammation.
  • Chest X-ray: This imaging technique demonstrates if the patient has significant pericardial effusion or if their pain comes from a different part of the body.
  • Echocardiogram: Using sound waves, this tool looks at heart structure and function. It also examines the pericardium.
  • Electrocardiogram: By looking at electrical activity in the heart, doctors can detect changes caused by pericarditis. Additionally, this test can point towards other reasons for the pain.
  • High-level imaging tests: If routine tests cannot establish a firm diagnosis, doctors may try CT scans and MRIs.

If pain relievers and anti-inflammatory drugs eased your pain initially, your doctor will likely prescribe the same medication again. They may also give you a corticosteroid if over-the-counter options do not provide relief. There is at least one FDA-approved medicine that specifically treats recurrent pericarditis currently. Depending on the circumstances of your case, the doctor may suggest an intervention, such as:

  • Pericardiocentesis to drain excess fluid from the pericardium
  • Pericardiectomy to remove the pericardium partially or entirely

Learn More about Recurrent Pericarditis

To find out more about recurrent pericarditis and other heart conditions like myocarditis, turn to Myocarditis Foundation for answers. We’re a private nonprofit organization that serves individuals suffering from these diseases, raising awareness and funds to support crucial research initiatives.  Contact us today for more information, or contribute to our nationwide impact with a donation.