Pericarditis
Pericarditis was found in 5-Minute Clinical Consult which helps you diagnose, treat, and follow up on over 900 medical conditions seen in everyday practice.

To view this entire topic, please or purchase a subscription.

Explore 5-Minute Clinical Consult - view these FREE monographs:

5-Minute Clinical Consult

-- The first section of this topic is shown below --

Basics

Description

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.

Epidemiology

Incidence
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)

Risk Factors

Genetics
No known genetic factors

Pathophysiology

  • 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).

Etiology

  • Idiopathic: 85–90% of cases. Likely related to viral infection (2)[B].
  • Infectious:
    • 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
    • Trauma
    • Postpericardiotomy
    • 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
    • Sarcoidosis
  • Medication-induced: Dantrolene, doxorubicin, hydralazine, isoniazid, mesalamine, methysergide, penicillin, phenytoin, procainamide, rifampin (1)

Commonly Associated Conditions

Depends on etiology

-- To view the remaining sections of this topic, please or purchase a subscription --