The pain is usually relieved by sitting up or bending forward, and worsened by lying down (both recumbent and supine positions) or by inspiration (taking a breath in). The pain may resemble that of angina but differs in that pericarditis pain changes with body position, where heart attack pain is generally constant and pressure-like. Other symptoms of pericarditis may include dry cough, fever, fatigue, and anxiety.Due to its similarity to the pain of myocardial infarction (heart attack), pericarditis can be misdiagnosed as a heart attack. Acute myocardial infarction can also cause pericarditis, but the presenting symptoms often differ enough to warrant diagnosis. The following table organizes the clinical presentation of pericarditis differential to myocardial infarction:

Physical examinations
The classic sign of pericarditis is a friction rub heard with a stethoscope on the cardiovascular examination, usually on the lower left sternal border. Other physical signs include a person in distress, positional chest pain, diaphoresis (excessive sweating); possibility of heart failure in form of pericardial tamponade causing pulsus paradoxus, and the Becks triad of low blood pressure (due to decreased cardiac output), distant (muffled) heart sounds, and distension of the jugular vein (JVD). Complications
Pericarditis can progress to pericardial effusion and eventually cardiac tamponade.
Colchicine may be added to the above as it decreases the risk of further episodes of pericarditis.Severe cases may require one or more of the following:
antibiotics to treat tuberculosis or other bacterial causes
steroids are used in acute pericarditis but are not favored because they increase the chance of recurrent pericarditis
pericardiocentesis to treat a large pericardial effusion causing tamponadeRecurrent pericarditis resistant to colchicine and anti-inflammatory steroids may benefit from a number of medicines that affect the action of interleukin 1; they cannot be taken in tablet form. These are anakinra, canakinumab and rilonacept. Rilonacept has been specifically approved as an orphan drug for use in this situation. Azathioprine has also been used.Surgical removal of the pericardium, pericardiectomy, may be used in severe cases and where the pericarditis is causing constriction, impairing cardiac function. It is less effective if the pericarditis is a consequence of trauma, in elderly patients, and if the procedure is done incompletely. It carries a risk of death between 5 and 10%. Epidemiology
About 30% of people with viral pericarditis or pericarditis of an unknown cause have one or several recurrent episodes. See also
Myopericarditis
Viral cardiomyopathy

References
External links
Pericarditis — National Library of Medicine
Pericarditis — National Heart Lung Blood Institute