Pericarditis

Examinations and Tests

Medical history and physical examination

A physical examination and a review of your medical history will help a doctor diagnose pericarditis, its complications, and any underlying conditions.

A doctor will ask questions about your symptoms and general health and may ask whether you've had any flu-like symptoms recently and whether you've ever had any serious infections, such as tuberculosis. Having had cancer, radiation treatments for cancer, or significant injuries to the chest are also important clues to help diagnose pericarditis.

Your doctor will listen to your heart for a sound called a pericardial friction rub, which often occurs with pericarditis. A pericardial friction rub sounds like Velcro being pulled apart. A friction rub is thought to be caused by tissue membranes as they rub together. Sometimes it is difficult to hear or recognize.

Electrocardiogram (EKG or ECG)

An inflamed pericardium can affect your heart's regular electrical impulses. An electrocardiogram (EKG or ECG) can identify any abnormal electrical activity.

Several electrocardiograms may be done over a period of weeks to monitor the heart during the treatment of pericarditis.

Chest X-ray

A chest X-ray can show the size of your heart. Your heart may be larger than normal if you have pericarditis. A chest X-ray can also help determine whether you have certain underlying causes, such as tuberculosis or pneumonia.

Echocardiogram

Echocardiogram (echo) is useful for diagnosing fluid around the heart (pericardial effusion). It is also used to check whether fluid is putting pressure on the heart (pericardial tamponade) and whether there is stiffening of the sac around the heart (constrictive pericarditis).

Blood tests

A variety of blood tests can help determine whether you have inflammation somewhere in the body, including the pericardium, or whether you have another condition that is causing the pericarditis.

Pericardiocentesis

Pericardiocentesis is a procedure that may be used if you have fluid buildup in the pericardium (pericardial effusion). During pericardiocentesis, a doctor numbs the skin on your chest, inserts a needle and sometimes a thin tube called a catheter into the area around the heart, and removes some fluid. This fluid can be sent to the lab for testing to help determine the cause of pericarditis. Removing fluid also relieves pressure on the heart.

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Author:	Douglas Dana Robin Parks, MS	Last Updated: June 21, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine E. Gregory Thompson, MD - Internal Medicine Stephen Fort, MD, MRCP, FRCPC - Interventional Cardiology
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