Sharp pain in the middle or left side of the chest that comes on suddenly is one of the fastest routes to an emergency room.
Most people fear the worst.
But an inflamed sac around the heart can produce almost the same alarm bells, and it behaves in a way a heart attack does not.
Per the American Heart Association, the pain from pericarditis is usually worse when lying on your back and often feels better when you sit up and lean forward.
Also read: 11,000 Americans sick from one lettuce source: what cyclospora does to your body
That positional pattern is the clearest tell separating it from a typical heart attack.
Pericarditis is inflammation of the pericardium, the fluid-filled pouch that surrounds the heart.
Cleveland Clinic estimates it accounts for about 5 percent of emergency room visits for chest pain and is most common in men between 20 and 50 years old.
The 7 warning signs to know
Drawing on the AHA symptom page, the NIH's National Heart, Lung, and Blood Institute and the StatPearls clinical reference, the pattern typically includes:
Also read: Could a daily pill replace your cholesterol shots?
- Positional chest pain: Sharp pain in the middle or left side of the chest, sudden onset, that worsens when lying flat and eases when sitting up and leaning forward. Pain may spread to the shoulders.
- Low-grade, intermittent fever: A mild fever that comes and goes is common in the acute phase.
- Dry cough: A nonproductive cough often accompanies the chest pain.
- Pericardial friction rub: A rasping, scratchy sound a doctor hears with a stethoscope, produced by the inflamed layers of the pericardium moving against each other. StatPearls reports it is present in 35 to 85 percent of cases.
- Palpitations: A sensation of the heart skipping, fluttering, or beating too hard or too fast.
- Shortness of breath: Trouble breathing, often more noticeable when lying down.
- Weakness and fatigue: A general drop in energy that can linger after other symptoms fade.
Muscle aches, hiccups or trouble swallowing can also appear, per Cleveland Clinic.
When to call 911, and when to see a doctor
The NHLBI is explicit. If you have chest pain or severe shortness of breath, or your symptoms get worse, call 9-1-1 or seek medical help right away.
Pericarditis symptoms can feel like a heart attack. Only tests such as an electrocardiogram, a chest x-ray, echocardiography and blood work can tell them apart with certainty, per the AHA.
Milder, positional chest discomfort that comes on after a recent respiratory illness is still a reason to see your doctor promptly, not at some later date.
Also read: She read every night for a week: Here’s how it affected her sleep
A viral infection is the most common trigger, so pericarditis is a real concern for anyone who has recently been ill.
Anti-inflammatories are the usual first line
Cleveland Clinic notes that nonsteroidal anti-inflammatory drugs are often the first-line treatment for acute pericarditis, with ibuprofen and aspirin among the common choices.
The StatPearls reference cites a typical regimen of ibuprofen 600 mg every 8 hours, with treatment continued until symptoms clear, which usually takes 3 days to 2 weeks.
Any dose and duration must come your own doctor.
Also read: How eating prunes every day can affect your body
Also read: Getting the shingles vaccine may cut your risk of developing dementia by nearly a quarter
This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.