Pericarditis: symptoms, causes, treatment and recovery

The NHS says the main symptom is chest pain. The pain usually feels sharp or stabbing, spreads to your shoulders, arms or tummy, gets worse when you breathe in deeply, swallow, cough or lie down (especially on your left side), and gets better when you lean forward. You may also have a high temperature or feel hot, cold or shivery, a cough and painful joints.

The British Heart Foundation (BHF) says some people have dull, pressure-like chest pain, that it may be felt on the left of the chest or behind the breastbone, and that other symptoms can include feeling sick, light-headed and short of breath.

The NHS says to ask for an urgent GP appointment or get help from NHS 111 if you have chest pain that is sharp or stabbing and gets worse when you take a deep breath in, swallow, cough or lie down.

It says to call 999 if you have sudden chest pain that spreads to your arms, back, neck or jaw, makes your chest feel tight or heavy, also started with shortness of breath, sweating and feeling or being sick, or lasts more than 15 minutes. You could be having a heart attack. Do not drive yourself to A&E. The BHF gives the same warning signs.

The NHS says your heart has a protective fluid-filled sac around it called the pericardium. In pericarditis the pericardium gets inflamed, and blood or fluid can leak into it. The BHF says pericarditis can sometimes happen together with myocarditis (inflammation of the heart muscle), known as myopericarditis, and that pericarditis is not usually a serious condition.

The NHS says treatment depends on what is causing it. You may be given anti-inflammatory painkillers such as ibuprofen to ease pain, and sitting up or leaning forward can help. A GP may prescribe colchicine if anti-inflammatory painkillers do not work or pericarditis keeps coming back, steroids if colchicine does not work, and antibiotics if pericarditis is caused by a bacterial infection.

The BHF adds that, rarely, if symptoms continue and get worse, a pericardial window (surgery to drain the inflamed lining) may be recommended. It says getting diagnosed and treated early can help you feel better and lower the risk of long-term complications.

The NHS says most people feel better within a few weeks. The BHF says most people recover from pericarditis within a few weeks, but for some it can take several months, and although it can be long-lasting most people recover within weeks.

The BHF says your body needs time to rest and recover, and that it is usually recommended to avoid high-intensity exercise for at least 3 months, though your doctor can advise on when and how to return to exercise and work.

The NHS says it is difficult to confirm the exact cause, but it is usually a viral infection such as a cold or flu. The BHF says it is most commonly caused by a virus, such as flu or Covid-19, or another infection, or by inflammatory conditions such as rheumatoid arthritis.

More rarely the BHF lists injury to the chest (for example after a car accident, heart surgery or heart attack), other health problems such as cancer, kidney failure or an underactive thyroid, and certain medicines or vaccines. Sometimes the cause cannot be found, which is called idiopathic pericarditis.

The NHS says a GP will listen to your heart, because pericarditis can change the sound your heart makes. To confirm it, the GP may do blood tests or refer you for a chest X-ray, electrocardiogram (ECG) or echocardiogram in hospital. The NHS says ECGs are safe and painless and some GPs can do them at the surgery.

The BHF says pericarditis can be hard to diagnose, and you may also have a cardiac MRI or CT scan. Blood tests check for infections and inflammation.

Chest pain always needs assessment, because pericarditis can feel like a heart attack. The NHS and BHF lists differ in the pattern, but only a clinician can tell them apart, so do not wait.

On the NHS, chest pain is assessed urgently by a GP, NHS 111 or emergency services, and tests are arranged through the GP or hospital. Cardiology teams look after people with recurrent or complicated pericarditis.

Private cardiology clinics also assess chest pain and arrange ECGs and echocardiograms. Because chest pain can be an emergency, the NHS advice on 999 applies whichever route you use.