Pericarditis

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What is pericarditis?

The heart is covered by a thin, sac-like membrane called the pericardium. In pericarditis (pear-i-car-DIE-tis), this membrane becomes irritated (inflamed).

The pericardium has 2 layers: an inner layer and an outer layer. Normally, there is a small amount of fluid between the layers. When the pericardium becomes inflamed, extra fluid is produced.

If a large amount of fluid builds up, the extra fluid can compress the heart and make it harder to pump. This is called cardiac tamponade (tam-pah-NAID). It is dangerous and can make the blood pressure drop too low.

What causes pericarditis?

Most of the time, pericarditis results from a viral infection.

In children, pericarditis may happen after heart surgery. This is called postpericardiotomy (post pear-i-car-dee-AH-toe-me) syndrome. This does not happen because of an infection. It happens because the surgeon had to cut through the pericardium to operate on the heart.

Pericarditis may also be caused by diseases, such as systemic lupus erythematosus or juvenile rheumatoid arthritis, or by medicines or radiation. This is less common.
Pericarditis after COVID-19 vaccination

Rarely, pericarditis or myocarditis has started in a patient soon after they received a COVID-19 mRNA vaccine, usually within a week after their second dose. Seattle Children’s doctors and researchers are leading work to better understand why this might happen, how to prevent it and how best to care for people who are affected.

Most patients recover well with treatment and feel better quickly. If your child has symptoms of pericarditis or myocarditis after being vaccinated against COVID-19 (or at any time), call your child’s primary care provider.

Learn more on the Centers for Disease Control and Prevention website.

Heart Center at Seattle Children's

Our pediatric cardiologists and cardiac surgeons have more advanced training and experience operating and performing procedures on babies, children and teens than at any other children's hospital in the Pacific Northwest.

Symptoms of Pericarditis

The main symptom of pericarditis is chest pain. Frequently, the pain is sharp. Often, it gets worse when the child lies down or breathes deeply and gets better when they sit up and lean forward.

A child with pericarditis may also:

Feel weak or more tired than normal
Have trouble breathing
Have a fever (at least 100° F or 37.8° C by mouth)

Diagnosing Pericarditis

Your child’s doctor will ask for details about any symptoms your child has, their health history and your family health history.

To diagnose pericarditis, the doctor will examine your child and use a stethoscope to listen to their heart and lungs. Sometimes, doctors can hear the sound of the inflamed pericardium rubbing on the heart. This is called pericardial friction rub. It is a sign of pericarditis.

Usually, children have an ECG or EKG (electrocardiogram) and echocardiography to help diagnose pericarditis and check their heart function. Sometimes they also need a CT (computed tomography) scan or an MRI (magnetic resonance imaging) of the heart.

Your child may also need blood tests to check for infection.

Treating Pericarditis

Pericarditis often gets better on its own after a few days or weeks. Depending on how severe it is, the doctor may suggest that your child get extra rest and take an over-the-counter medicine to help relieve their pain and inflammation. In more painful or severe cases, the doctor may prescribe stronger medicines for inflammation.

If a bacterial infection is the cause, the doctor may recommend medicine (antibiotics).

When pericarditis is severe, a large amount of fluid may build up in the pericardial sac. This can affect the heart’s ability to pump enough blood to the body, so the fluid may need to be drained. Doctors usually do this in the cardiac catheterization laboratory.

Pericarditis at Seattle Children’s

The experts you need are here
- Our team of more than 40 pediatric cardiologists has experience diagnosing and treating every kind of heart problem, including pericarditis.
- We have a great deal of experience with the treatments your child may need. These include medicines for inflammation and infection and a procedure to drain extra fluid from around the heart.
Care from birth through young adulthood
- Seattle Children’s cardiologists see babies, children and teens with pericarditis. We have experience checking pericarditis in kids of all ages to tell whether they need treatment.
- For children who need medicine or other care, we create a custom treatment plan.
Support for your whole family
- We are committed to your child’s overall health and well-being and to helping your child live a full and active life.
- Whatever types of care your child needs, we will help your family through this experience. We will discuss your child’s condition and treatment options in ways you understand and involve you in every decision.
- Our Child Life specialists know how to help children understand their illnesses and treatments in ways that make sense for their age.
- Seattle Children’s has many resources, from financial to spiritual, to support your child and your family and make your experience as smooth as possible.
- Read more about the supportive care we offer.