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WHAT IS PERICARDITIS?

The pericardium is a thin membrane that surrounds the heart like a sac. It provides lubrication for the heart, contains it within the chest cavity, and shields it from infection and other types of harm.

Pericarditis is a condition in which that lining becomes inflamed. The pain that occurs during a pericarditis episode is caused by the irritated layers of the pericardium rubbing against each other.

Types of Pericarditis

Pericarditis may occur as a one-time episode or it may recur. When pericarditis recurs more than 4 weeks after the first flare, it is called recurrent pericarditis.

A first or one-time episode of pericarditis is different from recurrent pericarditis in not only the number of times it occurs, but also what causes it and how it is treated.

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Did you know?

Episodes of pericarditis are commonly referred to as “flares.

FIRST OR ONE-TIME EPISODE OF PERICARDITIS

Causes of a one-time episode include:

Heart attack icon

Heart attack and heart procedures

Infection icon

Infection from a virus, bacteria, fungus, or parasite

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Certain medications, such as blood thinners or those for seizures or irregular heart beat

Pericardium injury icon

Injury to the pericardium, such as from an accident, radiation, or chemotherapy

Other illnesses icon

Other illnesses, especially autoimmune disorders such as lupus or rheumatoid arthritis

Idiopathic icon

Unidentified: most first or one-time episodes of pericarditis are idiopathic, which means “unknown”

WHAT IS RECURRENT PERICARDITIS?

Just like it sounds, recurrent pericarditis is when a pericarditis flare happens again.

The cause of recurrent pericarditis is different from a first or one-time episode of pericarditis. Recurrent pericarditis is an autoinflammatory disease, meaning the flares are caused by the immune system attacking the pericardium, with each attack causing inflammation that leads to more immune system response and more inflammation in an ongoing cycle. Recurrent pericarditis is a chronic condition that may last for years.

The Cycle of Autoinflammation IN RECURRENT PERICARDITIS

1

Pericardial cell damage causes the release of IL-1α.

2

IL-1α binds to macrophages (immune cells) causing the release of IL-1β.

3

IL-1 signals the immune system to send immune cells to the pericardium.

4

Additional cell damage causes the cycle of autoinflammation to continue.

SYMPTOMS OF PERICARDITIS AND RECURRENT PERICARDITIS

Even though first or one-time episodes and recurrent pericarditis are different, the symptoms are the same.

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Chest pain icon

Main symptom: chest pain that feels worse when breathing in or lying down

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Back, neck, or shoulder pain

Fever icon

Low-grade fever

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Cough

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Overall sense of weakness and fatigue

Shortness of breath icon

Shortness of breath when lying down

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Anxiety

Heart palpitations icon

Heart palpitations

Swelling icon

Swelling in the abdomen, legs, or feet

Real takes

HOW DO YOU KNOW A FLARE IS BEGINNING?

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Joao

A medical student who is living with recurrent pericarditis gives us his take on diagnosis and treatment issues.

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