How Is Pericarditis Diagnosed?

Your doctor will diagnose pericarditis based on your medical history and the results from a physical exam and tests.

Specialists Involved

Primary care doctors—such as a family doctor, internist, or pediatrician—often diagnose and treat pericarditis. Other types of doctors also may be involved. These include a cardiologist, pediatric cardiologist, and an infectious disease specialist. A cardiologist treats people who have heart problems. An infectious disease specialist treats people who have infections.

Medical History

To learn more about your medical history, your doctor may ask whether you:

• Have had a recent respiratory infection or flu-like illness
• Have had a recent heart attack or injury to your chest
• Have any other medical conditions

Your doctor also may ask about your symptoms. If you have chest pain, he or she will ask you to describe how it feels, where it’s located, and whether it’s worse when you lie down, breathe, or cough.

Physical Exam

When the pericardium (the sac around your heart) is inflamed, the amount of fluid between its two layers of tissue increases. As part of the exam, your doctor will look for signs of excess fluid in your chest.

A common sign is the pericardial rub. This is the sound of the pericardium rubbing against the outer layer of your heart. Your doctor will place a stethoscope on your chest to listen for this sound.

Your doctor may hear other chest sounds that are signs of fluid in the pericardium (pericardial effusion) or the lungs (pleural effusion). These are more severe problems related to pericarditis.

Diagnostic Tests

Your doctor may order one or more tests to diagnose your condition and show how severe it is. The most common tests are:

• EKG (electrocardiogram). This simple test detects and records the electrical activity of your heart. Certain EKG results suggest pericarditis.
• Chest x ray. A chest x ray takes pictures of your heart and lungs. The images can show whether you have an enlarged heart. This is a sign of excess fluid in your pericardium.
• Echocardiography. This painless test uses sound waves to create pictures of your heart. The pictures show the size and shape of your heart and how well your heart is working. This test can show whether fluid has built up in the pericardium.
• Cardiac CT (computed tomography). This is a type of x ray that takes a clear, detailed picture of your heart and pericardium. CT helps rule out other causes of chest pain.
• Cardiac MRI (magnetic resonance imaging). This test uses powerful magnets and radio waves to create detailed pictures of your organs and tissues. MRI can show changes in the pericardium.

Your doctor also may order blood tests. These tests can help your doctor find out whether you’ve had a heart attack, the cause of the pericarditis, and how inflamed your pericardium is.