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This is called pericarditis. An inflammation of the sac around the heart. Chest pain is very common. It can be caused by an infection or a heart attack. Pain is better with sitting up and leaning forward.

Heart attacks themselves do not feel better with these position changes. Heart attacks feel like an elephant on the chest and have pain radiating down the arm. It can be hard to make a diagnosis between the two.

Infection can be caused by fungi, bacteria, or viruses.

Aspirin, NSAIDS are given for this and at times steroids.

At times, the pericardial sac becomes restrictive and must be cut open to allow movement of the heart as it beats. This happens in chronic pericarditis. The heart when it beats, moves in a twisting way and needs room.

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Q: What happens if the pericardium becomes infected?
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