Chronic pericarditis

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Chronic pericarditis is inflammation of the pericardium (the flexible two-layered sac that envelops the heart) that begins gradually, is long-lasting, and results in fluid accumulation in the pericardial space or thickening of the pericardium.

Symptoms may include shortness of breath, coughing, and fatigue.
Echocardiography and sometimes other tests are used to make the diagnosis.
The cause, if known, is treated, or salt restriction and diuretics may be used to relieve symptoms.
Sometimes surgery to remove the pericardium is needed.

(See also Overview of Pericardial Diseaseand Acute Pericarditis.)
Pericarditis is considered chronic if it lasts longer than 6 months. There are two main types of chronic pericarditis.

Chronic effusive pericarditis
Chronic constrictive pericarditis

In chronic effusive pericarditis, fluid slowly accumulates in the pericardial space, between the two layers of the pericardium.
Chronic constrictive pericarditis, which is rare, usually results when scarlike (fibrous) tissue forms throughout the pericardium. The fibrous tissue tends to contract over the years, compressing the heart. The compression prevents the heart from filling normally and causes a form of heart failure. However, because of the compression, the heart does not enlarge as it does in most types of heart failure. Because higher pressure is needed to fill the compressed heart, pressure in the veins that return blood to the heart increases. As a result of the increased venous pressure, fluid leaks out and accumulates in other areas of the body, such as under the skin. Occasionally, constrictive pericarditis occurs more quickly (for example, within a few weeks after heart surgery) and is considered subacute.