Symptoms and Diagnosis of Pericarditis

Signs and symptoms of pericarditis

A common symptom of acute pericarditis is a sharp, stabbing chest pain, usually coming on quickly. It’s often is in the middle or left side of the chest, and there may be pain in one or both shoulders.

Sitting up and leaning forward tends to ease the pain, while lying down and breathing deep worsens it. Some people describe the pain as a dull ache or pressure in their chest.

The chest pain may feel like a heart attack. If you experience chest pain, call 911 right away because you may be having a heart attack.

Fever is another common symptom of acute pericarditis. Other symptoms are weakness, trouble breathing and coughing. Palpitations, which are feelings that your heart is skipping a beat, fluttering or beating too hard or too fast, may occur and can be a sign of deeper heart tissue involvement.

Chronic pericarditis often causes tiredness, coughing and shortness of breath. Chest pain is sometimes absent with this type of pericarditis. Severe cases of chronic pericarditis can lead to swelling in the stomach, feet, ankles and legs and hypotension (low blood pressure).

Complications of pericarditis

Two serious complications of pericarditis are cardiac tamponade and chronic constrictive pericarditis.

• Cardiac tamponade happens if too much fluid collects in the sac, putting pressure on the heart. This prevents the heart from properly filling with blood, so less blood leaves the heart, causing a sharp drop in blood pressure. Untreated cardiac tamponade can be fatal.
• Chronic constrictive pericarditis is a rare disease that takes time to develop. It leads to scar-like tissue forming throughout the sac around the heart. As the sac becomes stiff and unable to move properly, the scarred tissue starts to compress the heart and prevent it from functioning well.

Diagnosing pericarditis

A doctor diagnoses pericarditis based on your medical history, a physical exam and test results.

Specialists involved

Primary care doctors, such as a family doctor, internist or pediatrician, often diagnose and treat pericarditis. A cardiologist, pediatric cardiologist or infectious disease specialist may be involved, depending on the patient’s age and medical conditions.

Medical history

Your doctor may ask whether you have had:

• A recent respiratory infection or flu-like illness
• A recent heart attack or injury to your chest
• Other medical conditions

If you have chest pain (angina), your doctor 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 is inflamed, the fluid between the sac’s two layers of tissue increases. So 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 listen for this using a stethoscope.

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

Diagnostic tests

Your doctor may recommend tests to diagnose your condition and its severity. The most common tests are:

Learn more:

• View an animation of angina 

Written by American Heart Association editorial staff and reviewed by science and medicine advisors. See our editorial policies and staff.

Last Reviewed: Apr 8, 2021

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Costochondritis…a mysterious inflammation of the rib joints in your chest…or is it? – Sophie Cooke – Soft Tissue Therapy

• Post author:Sophie Cooke











• Post published:12th May 2020












• Post category:Uncategorised

From personal experience this condition is extremely painful, comes out of no where and stops you doing A LOT of things!! The month before the GP told me I had Costochondritis I was merrily running the Cardiff half marathon with not so much as a sniff of pain in my chest.

THEN all of a sudden, I had severe chest pain, breathlessness, fatigue and even chopping vegetables was an impossible task. Following an ambulance trip into A&E, full medical assessment and X-ray it was concluded I had Costochondritis. The advice ….. rest, take anti inflammatory medication, breath quietly and it will settle itself. Or will it?!

AFTER a month of this I began to get impatient, I spent hours on the internet researching what it actually is – in the hope for some sort of medical / logical explanation for the inflammation.

THEN I found Steve August, a physio based in New Zealand. For the first time an explanation as to the cause of this that made total sense. As a Soft Tissue therapist, we always look for the cause of pain and not just focus on treating the pain site itself. To have this explanation made all the difference.

FINALLY, A SIMPLE ANSWER! All hail Steve! The answer – the joints at the back of the rib cage (attached to the spine) are stiff and immobile and therefore the costochondral joints (the bits at the front) become overworked and more mobile to allow your body to breath ultimately causing them to strain. This inflammation creates pain and sensitivity and will continue until the immobile joints at the back are fixed!

FIXED! REALLY? YES!! Phew, I can hear your sigh of relief…this condition can be fixed.

Effective treatment includes the mobilisation of the stiff joints in your ribs that attach to your spine, deep tissue massage of your shoulders, neck and upper back combined with strengthening exercises and a focus on posture. I began my treatment journey with an Osteopath to free up my stiff rib joints and then maintained the release using the Backpod daily combined with a monthly deep tissue massage by a Soft Tissue therapist who knows how to treat costochondritis – it is very important they know what to do as some methods of treatment can make the inflammation worse. In between treatments I used various exercises to strengthen my shoulders and very quietly stretch my pectoral muscles. For more information on this please visit Costochondritis Explained

IMPORTANT If you have any chest pain, you MUST visit your GP for X-rays and tests to diagnose costochondritis and rule out any cardiac problems. Please ensure you do this before taking any of the above advice.

Mastitis (in women): symptoms, how to treat

Pain, redness of the skin in the area of ​​the mammary glands, bursting pains in the mammary glands – these symptoms may indicate the development of such a serious disease as mastitis. What is this pathology?

Pain, redness of the skin in the area of ​​the mammary glands, bursting pains in the mammary glands – these symptoms may indicate the development of such a serious disease as mastitis. What is this pathology? Who and why does it occur? How to prevent its development? The topic of mastitis is covered by the surgeon of the “Expert Clinic” Smolensk Efim Semyonovich Asnin.

– Efim Semyonovich, what is mastitis? Who usually develops it?

— Mastitis is an inflammation of the breast. It develops most often in women after pregnancy and the birth of a baby, as it is mainly associated with a violation of the normal outflow of breast milk (lactostasis). They constitute the risk group for the disease.

Mastitis of non-lactating (non-milk-producing) glands occurs, as a rule, in women under 30 and over 50 years of age.

How common is mastitis?

– 90% of all cases of mastitis occur during the period of breastfeeding, i.e., the inflammatory process develops in the lactating mammary gland. According to statistics, about 16% of breastfeeding women suffer from inflammation of the mammary glands. Among them, the vast majority of primiparas.

Mastitis in non-breastfeeding women occurs in 5-10% of cases.

“Breastfeeding is painful,” young mothers say. Is breastfeeding always painful for a woman? Quote from “Which of these is NOT true about breastfeeding?”

— What are the causes of mastitis?

– The main reason is the penetration of pathogenic microflora into the tissue of the mammary glands, in particular a bacterial infection (most often staphylococcal). If a woman does not properly attach her baby to her breast, if her nipples are not prepared, cracks may appear on them, forming an entrance gate for the penetration of microbes. Incomplete pumping of milk from the breast contributes to the development of lactostasis, and this is a favorable environment for the development of inflammation.

Mastitis can also be caused by a hormonal imbalance (namely, excessive production of the hormone prolactin, dysfunction of the thyroid gland), or abrupt weaning of the child from the breast.

Incorrect implantation, nipple piercings, and trauma to the mammary gland can also lead to the development of inflammation in it.

— Tell us about the types of mastitis

— Acute and chronic mastitis, unilateral and bilateral, are distinguished along the course. By the nature of the inflammatory process, they are serous, infiltrative, purulent, abscessing, gangrenous, phlegmonous. The first two forms are characterized by a limited focus of inflammation. When ensuring a good outflow of milk, they usually do not suppurate. All other forms of the inflammatory process require surgical intervention.

— What are the symptoms of mastitis?

— Painful sensations in the mammary gland when feeding a child, bursting pains in it, thickening of the gland tissue, reddening of the skin in this area, cracks and abrasions on the nipple and around it, enlargement of nearby lymph nodes, signs of intoxication — high fever, chills, headache. These symptoms should be a signal for a woman to see a doctor immediately.

In more advanced cases, discharge from the mammary glands mixed with pus and blood can be observed.

— What makes up the diagnosis of mastitis?

– First of all, from the collection of complaints and anamnesis, examination by a doctor. If necessary, it is recommended to conduct a series of blood tests, ultrasound of the mammary glands, bacteriological seeding of secretions from the mammary glands for microflora.

Read related materials:

What does breast ultrasound show?
Bacteria: find and identify. What will bakposev tell about?

— How and how is mastitis treated?

— Treatment tactics are selected by the doctor individually, depending on the form and severity of the inflammatory process. Of the conservative methods of treatment, antibacterial, anti-inflammatory, immunomodulatory therapy, some types of physiotherapy procedures are used.

If the inflammatory process progresses or there are cavities filled with pus in the gland, surgical intervention may be required.

Read related materials:

How to use antibiotics correctly? Instructions for use
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— How do you feel about traditional methods of treating mastitis?

– I can recommend proven folk remedies only after a personal examination of the patient, if I consider that they will be effective in this case.

— What should be done to avoid mastitis?

— First of all, observe the rules of personal hygiene when feeding and caring for the mammary glands, prevent congestion by regularly feeding the child with both glands in turn, followed by decanting milk residues. Contact obstetricians or lactation consultants for information on the technique and rules of feeding, pumping. It is important that a woman wears properly sized underwear made from natural fabrics.

A breastfeeding woman should not have chronic foci of infection in the body, so even during the planning of pregnancy, you should consult a doctor to eliminate them.

Relatives should provide a nursing woman with good nutrition, sleep, and protect her from stress and excessive physical exertion.

I urge women to immediately consult a doctor in case of any changes in the mammary glands. Do not forget that timely diagnosis and treatment will help to maintain lactation, not to resort to surgical intervention.

Interviewed by Sevilya Ibraimova

You can make an appointment with a surgeon here
ATTENTION: the service is not available in all cities

The editors recommend:

Is mastopathy dangerous? Don’t panic, but heal!
Breast fibroadenoma: how can a doctor help?
Breast cancer is not a sentence!
Do’s and Don’ts in the diet of a breastfeeding mother

For information:

Asnin Efim Semyonovich

In 1972 he graduated from the medical faculty of the Smolensk State Medical Institute.
In 1973 he completed his internship in the specialty “Surgery”.
Passed improvement in various areas of surgery, orthopedics.
Doctor of the highest category.
Currently – a surgeon at the “Expert Clinic” Smolensk. Accepts at: st. March 8, 20.

causes, symptoms, diagnosis and treatment in Moscow

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• Published: 6 December 2019

• Article updated: January 17, 2023

Mastitis is an acute or chronic inflammation of the mammary gland caused by the penetration of a bacterial infection through the injured nipple or skin of the breast through the lymphatic pathways. Most often, mastitis is diagnosed in a nursing woman. Also, the disease can develop in a pregnant woman, less often in girls, and sometimes, as a result of a malfunction of metabolic processes and disruption of the endocrine system, and in men.

At the very first symptoms of mastitis (tight and painful breasts, reddened skin, chills, fever), an examination by a specialist – a qualified mammologist – is necessary. Specialists of the NEARMEDIC network of clinics treat mastitis in accordance with international protocols. Experienced doctors provide professional medical care.

If you notice signs of mastitis, call us and make an appointment online.

Why are we

Experienced doctors

In the network of NEARMEDIC clinics, breast mastitis is treated by highly qualified mammologists, some of them have more than 25 years of experience. The most experienced specialists constantly improve their skills, undergo training in leading specialized centers, regularly take part in seminars and conferences dedicated to problems in mammology.

Powerful modern equipment

The clinics are equipped with the latest equipment manufactured by the world’s leading companies: high-precision digital ultrasound machines, X-ray units with reduced radiation dose, highly sensitive sensors, analog mammographs, etc.

Features of diagnosis and treatment of mastitis

Acute lactational mastitis begins abruptly and unexpectedly. Cracks appear on the nipples, bursting pains in the mammary gland. The chest swells, becomes painful, the skin may turn red, chills and hyperthermia appear – the body temperature rises to 39-40 degrees. It becomes more and more difficult to express breast milk, and severe pain is felt in the area of ​​​​redness.

Is it possible to breastfeed a child with mastitis? This is one of the most common questions, which, unfortunately, experts give a negative answer. Breastfeeding with any form of mastitis is prohibited due to the presence of pathogenic microorganisms in the milk, which can cause disruption of the gastrointestinal tract in an infant

But the chest must be pumped constantly, even when the pain is severe.

In some forms of the disease – infiltrative and serous mastitis, if there is no improvement after three days of treatment, mammologists suggest suppressing lactation.

If the cause of mastitis in women is not related to lactation or pregnancy, then we are talking about non-lactational mastitis. It occurs, as a rule, during the period of hormonal disorders – in women during menopause and menopause, in adolescents, and not only in girls, but also in boys. Sometimes mastitis in non-nursing occurs against the background of a decrease in immunity.

Diagnosis of mastitis

To confirm mastitis, a mammologist prescribes a microbiological examination of milk from both mammary glands. Laboratory research identifies the pathogen and assesses the degree of microbial colonization. The doctor also prescribes an analysis of women’s milk for leukocytes. The number of leukocytes in the disease is significantly increased, especially with purulent mastitis.

In destructive forms of the disease, a mammologist prescribes an ultrasound examination of the mammary glands, which makes it possible to accurately determine the localization of purulent contents. In chronic mastitis, mammography is prescribed – an X-ray examination of the breast, as well as a biopsy and subsequent histological examination for differential diagnosis with breast cancer.

Treatment of mastitis

Conservative treatment of the disease is carried out in the following cases:

• Satisfactory general condition of the patient;
• no more than three days have passed since the onset of mastitis;
• body temperature not higher than 37.5 degrees;
• no signs of purulent inflammation;
• the size of the palpable infiltrate is not more than one quadrant of the gland;
• moderate soreness in the area of ​​the infiltrate;
• parameters of the general blood test are normal.

If conservative treatment does not give visible results, this most often indicates purulent inflammation and is an indication for surgical intervention.

Treatment of acute non-lactational mastitis depends on the degree of the disease.