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Inflammation of the pericardium, with/without associated pericardial effusion. Myopericarditis or perimyocarditis refers to cases that have myocardial involvement in addition to the pericardial sac.
Epidemiologic studies lacking. Exact incidence unknown, but occurs in up to 5% of patients evaluated in the ER for chest pain without myocardial infarction (MI) (1)
No known genetic factors
- Inflammation of the pericardial sac can be acute or chronic (recurrent). Chronic/recurrent inflammation may result in constrictive pericarditis.
- Can produce serous/purulent fluid/dense fibrinous material (depending on etiology), which may or may not lead to hemodynamic compromise (cardiac tamponade).
- Idiopathic: 85–90% of cases. Likely related to viral infection (2)[B].
- Viral: Coxsackievirus, echovirus, adenovirus, Epstein-Barr virus, cytomegalovirus, hepatitis viruses, influenza virus, HIV, measles, mumps, varicella
- Bacterial: Gram-positive and gram-negative organisms
- Fungal (more common in immunocompromised populations): Blastomyces dermatitidis, Candida sp., Histoplasma capsulatum
- Mycobacterial: Mycobacterium tuberculosis
- Parasites: Echinococcus
- Noninfectious causes:
- Acute MI (2–4 days after MI), Dressler syndrome (weeks–months after MI)
- Aortic dissection
- Renal failure, uremia
- Malignancy (e.g., breast cancer, lung cancer, Hodgkin disease, leukemia, lymphoma)
- Radiation therapy
- After cardiac procedures (e.g., catheterization, pacemaker placement, ablation) (3)
- Autoimmune disorders: Connective tissue disorders, systemic lupus erythematosus (SLE), rheumatoid arthritis, scleroderma, hypothyroidism, inflammatory bowel disease, spondyloarthropathies, Wegener granulomatosis
- Medication-induced: Dantrolene, doxorubicin, hydralazine, isoniazid, mesalamine, methysergide, penicillin, phenytoin, procainamide, rifampin (1)
Commonly Associated Conditions
Depends on etiology