From the perspective of modern medicine, pericarditis refers to inflammation of the pericardium, the double-layered thin membrane enclosing the heart. What Donguibogam described as heat in pericardium collaterals corresponds directly to this inflammatory response. The pericardium reduces friction generated when the heart pumps vigorously, protecting it from external infection and trauma, functioning much like both a seatbelt and a lubricant for the heart.
When the pericardium becomes inflamed, its two layers rub against each other whenever the heart beats, producing sharp pain. This discomfort typically appears in the center or left side of the chest and tends to worsen during deep inhalation, coughing, or while lying flat. In severe cases, the pain may radiate to the back, neck, or shoulders. Just as Donguibogam noted that pain arises where there is heat, one of the most common causes of pericarditis is a viral infection. Common respiratory viruses, such as those causing colds or influenza, frequently reach the pericardium and trigger inflammation. In addition, it can stem from bacterial infection, autoimmune disease such as lupus or rheumatoid arthritis, renal failure, cancer, trauma, or a postoperative complication after heart surgery.
Although the inflammatory response is the body's natural defense mechanism against external invaders or injury, inflammation in the pericardium can directly compromise cardiac function. If fluid accumulates inside the pericardium due to inflammation, known as pericardial effusion, it compresses the heart and prevents it from expanding and contracting properly. The heart then cannot fill with or pump out sufficient blood, potentially leading to a medical emergency known as cardiac tamponade. This mechanical restriction is the direct cause of shortness of breath and chest tightness. If inflammation persists over time, the pericardium can thicken and stiffen, progressing into constrictive pericarditis that constricts the heart.
Beyond chest pain, symptoms may include fever, especially a low-grade fever, generalized fatigue, muscle pain, shortness of breath, and a dry cough. Because these signs resemble a common cold, they are easy to overlook. However, if chest pain persists or worsens in certain postures, a medical evaluation is necessary. An accurate diagnosis can be made using an electrocardiogram examination, blood test to check inflammatory markers, chest x-ray, and echocardiography. Depending on the underlying cause, treatment may require an anti-inflammatory agent, antibiotic, or steroid. Paying close attention to subtle signals from the body is essential, particularly when they involve the heart.
