CardiovascularPending review
Acute Pericarditis
Diffuse inflammation of the pericardial sac roughens its two layers so they rub together with every heartbeat, producing sharp pain that worsens lying flat and eases leaning forward, with widespread ECG changes because the injury current spreads across the whole heart rather than one coronary territory.
In a nutshell
Pericarditis is diffuse inflammation of the whole pericardial sac, producing sharp, positional, pleuritic pain from friction between the inflamed layers, and widespread rather than territorial ECG changes. The main danger is a pericardial effusion progressing to tamponade, a purely mechanical complication.
Classic presentation
A young adult after a viral illness develops sharp central chest pain that worsens lying flat and improves sitting forward, with a friction rub and diffuse ST elevation on ECG.
Key points
- Pain worse lying flat and relieved by sitting forward is a directly mechanical consequence of pericardial friction and is highly specific to pericarditis.
Educational content pending clinical review. Not medical advice.