Pericarditis and myocarditis: What’s the difference?

Written by: Dr Francesco Lo Monaco
Edited by: Karolyn Judge

Myocarditis and pericarditis are both inflammatory conditions that affect the heart, however they affect different areas of this organ.


Here to explain them in further, expert detail is leading associate specialist in cardiology Dr Francesco Lo Monoco.


Woman with a red paper heart - the real thing can be affected by pericarditis and myocarditis


What is pericarditis?

It is the inflammation and swelling of the thin, saclike tissue which surrounds the heart, called the pericardium. Chest pain, which is common symptom of pericarditis, is caused by the inflamed layers of the pericardium rubbing against each other.


Medication and on rare occasion, surgery, may be used to treat more severe cases. However, pericarditis is usually mild and resolves by itself.   


Lowering the risk of long-term consequences may work via early detection and treatment of pericarditis. MRIs, CT scans and transthoracic echocardiograms can be used to detect pericarditis, alongside simple stethoscope readings to detect the ‘pericardial rub’.  



What are the symptoms of pericarditis?

The primary symptom of pericarditis is chest pain; stabbing chest pain in particular. It may include increased chest pain upon coughing or inhalation. Other symptoms can manifest as:


  • Back pain around the shoulder blades

  • A cough that’s dry

  • Palpitations in the heart

  • Fatigue

  • Fever

  • Sore through

  • Shortness of breath


Acute pericarditis lasts for three weeks or less, and it appears rapidly. Also, it’s possible to have future episodes. It can be difficult sometimes to distinguish acute pericarditis pain from the pain caused by a heart attack.      


Recurrent pericarditis develops over four to six weeks following an episode of acute pericarditis, with no symptoms in the interim. Incessant pericarditis lasts between four to six weeks but less than three months. Also, the signs and symptoms don’t stop (hence the word recurrent).  


Pericarditis that’s determined as chronic constrictive pericarditis, is characterised by a gradual onset. Plus, it can last for more than three months.



How is myocarditis defined?

It’s heart muscle inflammation (myocardium), which can impair the heart’s ability to pump blood. This results in fast or irregular heartbeats, or arrhythmias, and it can produce blood clots. This can lead to a heart attack, stroke or heart damage – and in severe cases, death.


During a physical examination, myocarditis can be detected - or at least suspected – due to indications of swelling in the legs and feet, or an irregular heartbeat. Your doctor might send you for an X-ray, ECG, MRI or transthoracic echocardiogram test if myocarditis is suspected.   



What are myocarditis’ symptoms?

It can sometimes present without any other symptoms, apart from feet and leg swelling, or pleuritic chest pain. The most common symptoms of myocarditis include rapid or irregular heartbeat, fatigue and joint stiffness as well as shortness of breath and light-headedness.  


Other symptoms of myocarditis can include:

  • Fever

  • Headache

  • Sore throat

  • Body aches


It can be acute or chronic. Acute myocarditis resolves more easily, and it’s generally classified this way when the time between symptoms appearing and the time you are diagnosed is less than a month. After treatment, the majority of acute myocarditis cases improve directly or shortly afterwards.


When your symptoms persist or become increasingly difficult to manage, this is what’s known as chronic myocarditis. It appears to be related to the response of the immune system, while in reality, it’s frequently connected to autoimmune illnesses. This can lead to an increase in body inflammation.



What are the differences between pericarditis and myocarditis?

The two conditions have many similarities, and they can be interrelated because both of them are heart conditions. Myocarditis is an inflammation of the heart muscle, while pericarditis is an inflammation of the heart’s lining, to put it simply.


Pericarditis and myocarditis are usually secondary to a viral infection, like COVID, and have become very common. Both conditions usually present with symptoms such as chest pain, and can also cause shortness of breath and heart palpitations. Chronic inflammatory issues such as arthritis, lupus or other disease may also cause pericarditis and myocarditis.



How is pericarditis and myocarditis diagnosed?    

If you’re suffering from either pericarditis or myocarditis, or both, your doctor will be able to find out. What’s the most important is that you see a physician that can recommend that correct course of action and book the right tests, whether that’s a blood test or a private transthoracic echocardiogram test, for you.



If you’re concerned about either pericarditis or myocarditis arrange a consultation with Dr Lo Monaco, who can expertly address your queries, by visiting his Top Doctors profile.  

By Dr Francesco Lo Monaco

Dr Francesco Lo Monaco is an award-winning and highly rated cardiologist in London, who has just been recognised for his expertise in clinical cardiology in the European Awards in Medicine/Cardiology category 2022* He is expert in clinical cardiology and cardiac imaging, particularly in echocardiograms, electrocardiograms (ECG), stress tests, palpitations and heart check-ups. Dr Lo Monaco also sees private patients at a range of locations in central and west London including Chelsea and Westminister Hospital, 104 Harley Street, One Welbeck Heart Health as well as at the BMI Syon Clinic in Brentford.

*Dr Lo Monaco is a winner in the European Awards in Medicine 2022. Held every year at the Ritz Hotel in Paris, this prestigious award ceremony celebrates the professional achievements of specialists that have excelled in every field of medicine. Dr Lo Monaco has distinguished himself for his exceptional achievements in clinical cardiology. Read more about his achievement on the European Awards in Medicine website

Dr Lo Monaco qualified in medicine with honours from the University of Pavia, Italy in 1997. He then completed specialist training in cardiology in Milan and worked in the city as a consultant cardiologist for several years. In 2006 he relocated to New York to undergo a postdoctoral fellowship in cardiology at the New York Medical College. During this period, Dr Lo Monaco qualified in medicine in the USA and published ground-breaking research related to cardiac stem cells. He went on to present his findings at 2008’s American Heart Association meeting, held in New Orleans. In 2009, he was appointed as a specialist cardiologist within Chelsea and Westminster NHS Trust. Since then, Dr Lo Monaco has worked at several locations in central London as an associate specialist in cardiology, providing general cardiology care and cardiac imaging services for his patients.

Additional to his clinical work, Dr Lo Monaco is also actively involved in education and has been an honorary senior clinical lecturer and undergraduate tutor at Imperial College London since 2013. He is also an affiliate member of the Royal College of Physicians. In 2022, Dr Lo Monaco's significant contributions to his field were recognised when he won the Cardiology Award at the European Awards in Medicine.

Dr Lo Monaco appreciates that concerns about heart health can be worrying and offers same-day appointments at multiple locations as well as onsite exercise tolerance testing and twenty-four hour ECG Holter Monitor testing for the convenience of his patients. He additionally offers a free initial online consultation to discuss any problems you may experiencing and accepts all types of private health insurance.

View Profile

Overall assessment of their patients

  • Related procedures
  • Heart attack
    Hypertension (high blood pressure)
    Heart failure
    Injury valves
    Heart murmur
    Ambulatory electrocardiogram (Holter)
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.