Pericarditis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Pericarditis?
A cardiologist, a doctor who treats heart conditions, often manages pericarditis. A primary care doctor can also check for it, because the main symptom is chest pain. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is pericarditis?
Pericarditis is a problem in which the sac-like covering around the heart, called the pericardium, becomes inflamed. Inflamed means red, swollen, and irritated. It can range from a mild illness that gets better on its own to a life-threatening condition.
Fluid can build up in the sac. This is called pericardial effusion. If the fluid builds up too much, it can keep the heart from working well. Doctors call that cardiac tamponade.
Symptoms
Chest pain is almost always present. The pain often has these features:
- Sharp and stabbing, and it can be felt in the neck, shoulder, back, or belly.
- It often gets worse with deep breathing and lying flat, and it may get worse with coughing and swallowing.
- It is often relieved by sitting up and leaning or bending forward.
An infection can also cause fever, chills, or sweating. Other symptoms may include swelling in the ankles, feet, and legs, anxiety, trouble breathing when lying down, a dry cough, and tiredness.
Causes and who gets it
In many cases, the cause is unknown or unproven. Pericarditis mostly affects men ages 20 to 50 years. It is often the result of an infection, such as a virus that causes a chest cold or pneumonia. Bacterial infections are less common, and some fungal infections are rare causes.
It may also be seen with other health problems. These include autoimmune diseases, which happen when the immune system attacks healthy body tissue by mistake. They also include cancer, HIV infection, an underactive thyroid, kidney failure, rheumatic fever, and tuberculosis.
Other causes include a heart attack, heart surgery, an injury to the chest, swelling of the heart muscle, and radiation therapy to the chest. Certain medicines can also cause it.
How doctors diagnose it
A doctor listens to your heart with a stethoscope. The doctor may hear a sound called a pericardial rub, and the heart sounds may seem muffled or distant.
Imaging tests can check the heart and the covering around it. These include a chest x-ray, an echocardiogram (an ultrasound picture of the heart), an electrocardiogram (ECG, which records the heart's electrical activity), and heart MRI or CT scans. A blood test called troponin I can look for heart muscle damage. Other blood tests can check for infection or swelling in the body.
Treatment
Treatment depends on what is causing the problem. Doctors try to find the cause if they can. Anti-inflammatory painkillers such as ibuprofen are often given with a medicine called colchicine. They ease pain and reduce swelling in the pericardium. You may take them for days to weeks, or longer in some cases. Sitting up or leaning forward can also help ease the pain.
Antibiotics are used for a bacterial infection, and antifungal medicines for a fungal one. Some people also get corticosteroids, which calm swelling, or water pills to remove extra fluid.
If extra fluid keeps the heart from working well, a doctor may drain it with a needle. This is called pericardiocentesis. Surgery called pericardiectomy may be needed if the problem is long-lasting, comes back after treatment, or causes scarring or tightening around the heart. It cuts or removes part of the pericardium.
The outcome is good if pericarditis is treated right away. Most people recover in 2 weeks to 3 months. The condition may come back.
When to see a doctor
Contact your doctor if you have symptoms of pericarditis. It is not life threatening most of the time. However, it can be very dangerous if not treated.
Call 911 or go to the emergency room if you have chest pain or discomfort that lasts two minutes or more, spreads to your arms, back, neck, or jaw, makes your chest feel tight or heavy, or comes with shortness of breath, sweating, and feeling sick. Also call if you faint or have trouble breathing. You could be having a heart attack. Do not drive yourself.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can listen to your heart, order tests, and follow up after treatment.
Common questions
Is pericarditis serious?
Pericarditis is not life threatening most of the time. However, it can be very dangerous if it is not treated. It can also cause fluid buildup around the heart and poor heart function.
How long does pericarditis last?
Most people recover in 2 weeks to 3 months. The NHS says most people feel better within a few weeks. The condition may come back.
Can pericarditis come back?
Yes, it can. It is called recurrent, or chronic, if symptoms or episodes continue. A doctor may prescribe colchicine if pericarditis keeps coming back.
What does pericarditis chest pain feel like?
The pain can feel sharp and stabbing. It often gets worse with deep breathing and when lying flat. It is often relieved by sitting up and leaning or bending forward.
Can pericarditis be prevented?
Many cases cannot be prevented.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
