Pericarditis: A Potential Complication of Cancer Therapy

Lesser-known Complications Include Pericarditis


Treatment for cancer is often life-saving, but can bring with it potential side effects and complications. While many are aware of side effects such as hair loss and nausea, there are some lesser-known complications, such as pericarditis, that may also occur.

What Is Pericarditis?

The term “pericarditis” literally means “inflammation of the pericardium.” The pericardium, in turn, is the sac of fibrous tissue that surrounds and contains the heart.

Thus, pericarditis refers to inflammation of this sac around the heart.

What Are the Symptoms of Pericarditis?

Pericarditis almost always causes chest pain, so most patients will note pain in their chest that worsens when they inhale, or take a breath in. Chest pain due to pericarditis can be severe, may begin abruptly, and can radiate to the upper back. This pain is almost always relieved by leaning or sitting forward, and becomes worse upon lying down.

Depending upon the type and cause of pericarditis, other symptoms that may occur include shortness of breath, fast heart rate (rapid pulse, or tachycardia), anxiety, and low-grade fever.

What Causes Pericarditis?

There are a number of different causes of pericarditis. When it comes to cancer, some cancers themselves—such as lymphoma, breast cancer and lung cancer, among others—can cause pericarditis, while in other patients, the cause of pericarditis may be treatment for cancer.

Radiation therapy in particular is known to be a cause of pericarditis, which may occur several years after cancer treatment.

Pericarditis is recognized as a form of cardiotoxicity that may occur due to cancer therapy. An entire new field of medicine, known as cardio-oncology, has arisen to address specifically this issue of potential damage that may occur to the heart during otherwise life-saving treatment in the fight against cancer.

How Is Pericarditis Treated?

Treatment for pericarditis depends on the type of pericarditis that is present. Diagnostic tests such as echocardiography (ultrasound of the heart) are used to help categorize the diagnosis and to search for other conditions that may be associated with pericarditis, such as pericardial effusion (fluid in the sac around the heart).

For the chest pain associated with pericarditis, short-term treatment with nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be very helpful. For those who do not find adequate relief with NSAIDs, their physician may prescribe a course of colchicine, which is another medication that has been found helpful in treating some sources of inflammation.

For more serious cases of pericarditis, such as constrictive pericarditis, further intervention is usually necessary. Constrictive pericarditis, which is a relatively uncommon form of pericarditis, causes the pericardium to become rigid and tight around the heart, which makes it difficult for the heart to function properly.

In this case, a surgical procedure known as pericardiectomy (removal of the pericardium) is often required.

A small number of cases of pericarditis cases may become complicated by cardiac tamponade, which is a condition in which too much fluid builds up in the pericardial sac, putting so much pressure on the heart that it is hard for the heart to pump blood effectively. In such a case, a procedure known as pericardiocentesis, which drains the extra fluid out under local anesthesia, can be performed to relieve the pressure.

It is important to keep in mind that any patient who develops new symptoms of chest pain should seek medical attention immediately, regardless of what you think the cause may be. A physician or other healthcare professional can sort out the many different possibilities and guide care according to the appropriate diagnosis.


Bonow R et al. Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 9th edition. Elsevier Saunders: Philadelphia. 2012.

Hong RA, Iimura T, Sumida KN, Eager RM. Cardio-oncology/onco-cardiology. Clin Cardiol 2010;33:733-737.

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