Pericarditis - after heart attack

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Acute MI Post-MI pericarditis Pericardium

Overview Symptoms Treatment Prevention

Pericarditis - after heart attack

• chest pain
  • may come and go (recurrence)
  • pain radiates to the neck, shoulder, back, or abdomen
  • described as sharp and stabbing (pleuritic)
  • or described as tight and crushing (ischemic)
• chest pain may increase with breathing and may be relieved by an upright, standing or sitting position
• splinting of ribs (bending over or holding the chest) with deep breathing
• difficulty breathing
• dry cough
• anxiety
• fatigue
• fever
• general ill feeling (malaise)
• fast heart rate (tachycardia)

Using a stethoscope, the doctor will listen for a pericardial rubbing sound (not be confused with a murmur), and heart sounds may be weak or distant. Collections of fluid in the pericardial sac or in the space around the lungs (pleural effusion) are not common after heart attack. They do occur with chronic post-MI pericarditis (Dressler's syndrome).

Tests may include:

• Chest X-ray
• Echocardiogram
• Chest MRI
• Chest CT scan
• ECG
• Cardiac markers (CK-MB and troponin may distinguish pericarditis from acute MI)
• Complete blood count shows increased white blood cells
• ESR (sedimentation rate) is high

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