From the Guidelines
Pericarditis is characterized by a sharp, stabbing chest pain that is typically located in the center or left side of the chest, worsening with lying down, deep breaths, coughing, or swallowing, and improving when sitting up and leaning forward. This type of pain is often described as positional and respiratory-dependent, distinguishing it from the pain associated with a heart attack 1. The pain can radiate to the neck, shoulders, back, or abdomen and may be accompanied by other symptoms such as fever, weakness, fatigue, and shortness of breath.
Key Characteristics of Pericarditis Pain
- Sharp, stabbing quality
- Central or left-sided chest location
- Exacerbated by lying down, deep breathing, coughing, or swallowing
- Relieved by sitting up and leaning forward
- Positional and respiratory-dependent
- May radiate to the neck, shoulders, back, or abdomen The pain in pericarditis occurs due to the inflammation of the pericardium, which causes friction between its layers during heart movement, and can be triggered by various factors including viral infections, autoimmune disorders, heart attacks, certain medications, or trauma to the chest 1.
Management of Pericarditis Pain
- Anti-inflammatory medications such as NSAIDs (e.g., ibuprofen, aspirin) or colchicine are commonly used to reduce inflammation and manage pain 1.
- Restricting physical activity beyond ordinary sedentary life until resolution of symptoms and normalization of CRP is recommended for patients not involved in competitive sports 1.
- For athletes, a minimal restriction of 3 months after the initial onset of the attack is suggested, with return to competitive sports only after symptoms have resolved and diagnostic tests have been normalized 1.
From the Research
Type of Pain in Pericarditis
The type of pain associated with pericarditis is typically:
- Sharp or stabbing chest pain that may radiate to the back, neck, or arms
- Pain that worsens with deep breathing, coughing, or movement
- Pain that improves with sitting up or leaning forward
Treatment of Pericarditis Pain
The treatment of pericarditis pain typically involves:
- Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen to reduce inflammation and relieve pain 2, 3, 4
- Colchicine to prevent recurrences of pericarditis 5, 6
- Corticosteroids may be used in some cases, but their use is generally reserved for specific situations, such as autoimmune disorders or pregnancy 2, 3
Characteristics of Pericarditis Pain
The pain associated with pericarditis is often described as:
- Sudden onset and severe
- Constant or intermittent
- Worsening with movement or deep breathing
- Improving with rest or sitting up
- Accompanied by other symptoms such as fever, fatigue, or shortness of breath
Management of Pericarditis Pain
The management of pericarditis pain involves: