Pericarditis causes: Difference between revisions

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__NOTOC__
{{Pericarditis}}
{{Pericarditis}}
 
{{CMG}}; {{AE}} {{M.P}} {{AZ}}{{Homa}}
{{CMG}}


==Overview==
==Overview==
Pericarditis can present as a disorder primarily involving the pericardium (e.g viral etiologies), as manifestation of a systemic illness (e.g. autoimmune illnesses), or as a manifestation of a disorder involving an adjacent anatomic structure (e.g. cancer).
The [[causes]] of pericarditis can be divided into [[infectious]] and [[Infectious|non-infectious]] ones. [[Infectious]] causes include [[bacterial]], [[viral]], [[fungal]] and, [[parasitic]]. While, non-[[infectious]] causes include [[autoimmune]], [[neoplastic]], [[metabolic]], [[Trauma|traumatic]] and [[iatrogenic]], and [[Drug-related pericarditis|drug-related.]] [[Acute myocardial infarction]], [[Addisonian crisis]], [[aortic dissection]] and [[Aortic rupture|rupture]], [[chest trauma|blunt or penetrating chest trauma]], [[esophageal perforation]], [[Perforation|gastric perforation]], and [[myocardial rupture]] are life threatening [[causes]] of pericarditis. Common [[causes]] of pericarditis include [[viral]], [[bacterial]] [[organisms]], [[neoplasms]], [[autoimmune]] and [[renal failure]].


===Common Causes of Pericarditis <small><ref name="maisch">{{cite journal | author= Maisch B, Ristic AD | title= The classification of pericardial disease in the age of modern medicine | journal= Curr Cardiol Rep | year=2002 | pages=13–21 | volume=4 | issue=1 | pmid=11743917 | doi= 10.1007/s11886-002-0121-6}}</ref></small>===
==Causes==
===Life Threatening Causes===
Life-threatening [[causes]] include conditions which may result in death or permanent [[disability]] within 24 hours if left untreated and include:<ref name="Imazio2012">{{cite journal|last1=Imazio|first1=Massimo|title=Contemporary management of pericardial diseases|journal=Current Opinion in Cardiology|volume=27|issue=3|year=2012|pages=308–317|issn=0268-4705|doi=10.1097/HCO.0b013e3283524fbe}}</ref><ref name="ImazioSpodick2010">{{cite journal|last1=Imazio|first1=Massimo|last2=Spodick|first2=David H.|last3=Brucato|first3=Antonio|last4=Trinchero|first4=Rita|last5=Adler|first5=Yehuda|title=Controversial Issues in the Management of Pericardial Diseases|journal=Circulation|volume=121|issue=7|year=2010|pages=916–928|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.108.844753}}</ref><ref name="ImazioBrucato2009">{{cite journal|last1=Imazio|first1=Massimo|last2=Brucato|first2=Antonio|last3=DeRosa|first3=Francesco Giuseppe|last4=Lestuzzi|first4=Chiara|last5=Bombana|first5=Enrico|last6=Scipione|first6=Federica|last7=Leuzzi|first7=Stefano|last8=Cecchi|first8=Enrico|last9=Trinchero|first9=Rita|last10=Adler|first10=Yehuda|title=Aetiological diagnosis in acute and recurrent pericarditis: when and how|journal=Journal of Cardiovascular Medicine|volume=10|issue=3|year=2009|pages=217–230|issn=1558-2027|doi=10.2459/JCM.0b013e328322f9b1}}</ref><ref name="SliwaMocumbi2009">{{cite journal|last1=Sliwa|first1=Karen|last2=Mocumbi|first2=Ana Olga|title=Forgotten cardiovascular diseases in Africa|journal=Clinical Research in Cardiology|volume=99|issue=2|year=2009|pages=65–74|issn=1861-0684|doi=10.1007/s00392-009-0094-1}}</ref>
*[[Acute myocardial infarction]]
*[[Addisonian crisis]]
*[[Aortic dissection]]
*[[Aortic rupture]]
*[[chest trauma|Blunt or penetrating chest trauma]]
*[[esophageal rupture|Esophogeal perforation]]
*[[perforation|Gastric perforation]]
*[[Myocardial rupture]]


* (35%) Neoplastic
===Common Causes===
* (23%) Autoimmune
* [[Acute myocardial infarction]]
* (21%) Viral - [[adenovirus]], [[enterovirus]], [[influenza virus]] etc.
* [[Cardiac catheterization]]
* ( 6%) Bacterial (other than [[tuberculosis]])
* [[Staphylococcus aureus]] (MSSA, MRSA)
* ( 6%) [[Uremia]]
* [[Streptococcus pneumoniae]]
* ( 4%) [[Tuberculosis]]
* [[Neisseria meningitidis]]
* ( 4%) Idiopathic
* [[Enterobacteriaceae]]
* (remaining) [[trauma]], drugs, [[Dresslers' syndrome|post-AMI]], [[myocarditis]], [[dissecting aortic aneurysm]], [[radiation]]
* [[Tuberculosis]]
* [[Histoplasmosis]]
* [[Coxsackie B virus]]
* [[Echovirus]]
* [[HIV]]
* [[Adenovirus]]
* [[Influenza]]
* [[Neoplasm]]
* [[Renal Failure]]
* [[Sulfa drugs]]
* [[Aminosalicylic acid]]
* [[Amiodarone]]
* [[Systemic lupus erythematosus]]
* [[Rheumatoid arthritis]]
* [[Idiopathic]]


===Complete Differential Diagnosis of the Causes of Pericarditis===
===Causes by Organ System===
(By organ system)
{|style="width:70%; height:100px" border="1"
{|style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |Post-MI pericarditis in the immediate days following [[acute MI]] and [[Dresslers syndrome]] which develops later; [[dissecting aortic aneurysm]]; and underlying [[myocarditis]].
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Acute myocardial infarction]], [[aortic rupture]], [[thoracic duct|benign obstruction of thoracic duct]], [[dissecting aortic aneurysm]], [[Dresslers syndrome]], [[endocarditis]], [[myocardial rupture]], [[myocarditis]]
 
Following cardiovascular procedures such as: cathether ablation for [[arrhythmias]], coronary artery bypass grafting (CABG) ([[postpericardiotomy syndrome]]), [[pacemaker]] insertion, [[percutaneous coronary intervention]] with either dissection or perforation of the coronary artery, [[TAVI]], thoracic surgery (resulting in [[chylopericardium]]), [[valvuloplasty]].
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
| '''Chemical / poisoning'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Scombrotoxic fish poisoning]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"|Usually associated with small effusions.  Common culprits include [[hydralazine]], [[procainamide]], DOH, [[isoniazid]], [[phenylbutazone]], [[dantrolene]], [[doxorubicin]], methylsergide, [[penicillin]].
|bgcolor="Beige"| [[Aminosalicylic acid]], [[amiodarone]], [[anticoagulants]], [[bromocriptine]], [[cromolyn sodium]], [[certolizumab pegol]], [[cyclosporine]], [[cyclophosphamide]], [[cytarabine]], [[dantrolene]], [[daunorubicin]], [[doxorubicin]], [[Doxycycline]], [[5-fluorouracil]], [[hydantoin]], [[hydralazine]], [[isoniazid]], [[mesalazine]], [[methyldopa]], [[methysergide]], [[minoxidil]], [[Olsalazine]], [[penicillin]], [[Pergolide]], [[phenylbutazone]], [[practolol]], [[pramipexole]], [[procainamide]], [[procainamide]], [[reserpine]], [[ropinirole]], [[streptokinase]], [[streptomycin]], [[sulfa drugs]], [[Thalidomide]], [[thiazides]], [[thiouracil]], [[thrombolytics]], [[tocainide]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"|[[Temporal arteritis]]
|bgcolor="Beige"|[[Temporal arteritis]]
|-  
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"|Usually in conjunction with clinically severe [[hypothyroidism]].  Most early case reports associated with [[myxedema]] and patients also had [[ascites]], [[pleural effusion]]s and uveal edema. Often resolves with thyroid replacement therapy.  A pericardial effusion can be seen as part of an [[Addisonian crisis]].
|bgcolor="Beige"| [[Addisonian crisis]], [[hypothyroidism]], [[myxedema]]
|-  
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Asbestosis]], [[polytetrafluoroethylene|polytetrafluoroethylene inhalation]], [[silicosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"|[[Inflammatory bowel disease]], [[Whipple's]]
|bgcolor="Beige"|[[Inflammatory bowel disease]], [[Whipple's disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Gaucher disease]], [[Jacobsen syndrome|Jacobs arthropathy-camptodactyly syndrome]], [[Mulibrey nanism|Mulibrey nanism syndrome]], [[recurrent hereditary polyserositis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"| [[Leukemia]], [[Lymphoma]]
|bgcolor="Beige"| [[Leukemia]], [[lymphoma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| [[Chylopericardium]] (from [[thoracic duct]] obstruction secondary to tumor, surgical procedure), [[Post-pericardiotomy syndrome]], [[Radiation therapy]], [[Serum sickness]]
|bgcolor="Beige"| [[Cardiac catheterization]], [[cardiopulmonary resuscitation]], [[catheter ablation|cathether ablation for arrhythmias]], [[CABG|coronary artery bypass grafting]], [[dialysis]], [[heart surgery]], [[pacemaker syndrome]], [[percutaneous coronary intervention]], [[postpericardiotomy syndrome]], [[radiation therapy]], [[TAVI]], [[thoracic surgery]], [[Vaccines|vaccines (smallpox, yellow fever)]], [[valvuloplasty]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"|'''Viral:''' [[Coxsackie B Virus]], [[Echovirus]], [[Adenovirus]] (less commonly: [[CMV]]-especially in [[HIV]] patients, [[EBV]], [[Hepatitis B]], [[Influenza]], [[Mumps]], [[Varicella]]).
|bgcolor="Beige"| [[Actinomycosis]], [[adenovirus]], [[alveolar hydatid disease]], [[amebiasis]], [[aspergillus]], [[blastomycosis]], [[borrelia]], [[brucellosis]], [[candida]], [[chlamydia psittaci]], [[coccidiomycosis]], [[coxsackie B virus]], [[cytomegalovirus]], [[E.coli]], [[EBV]], [[echinococcus]], [[ECHO virus]], [[entamoeba histolytica]], [[francisella]], [[haemophilus influenza]], [[hepatitis B]], [[herpes viruses]], [[histoplasmosis]], [[HIV]], [[infectious mononucleosis]], [[influenza]], [[klebsiella]], [[legionella]], [[Lyme disease]], [[meningococci]], [[mumps]], [[mycobacterium tuberculosis]], [[mycoplasma]], [[neisseria]], [[nocardia]], [[pneumococcus]], [[proteus]], [[pseudomonas]], [[rickettsia]], [[salmonella]], [[staphylococcus]], [[streptococcus]], [[toxoplasmosis]], [[tularemia]], [[ureaplasma]], [[varicella]]
 
'''Tuberculous:''' usually bloody, protein greater than 2.5. Initially mostly [[polymorphonuclear cells]], later [[lymphocytes]], [[monocytes]] and [[plasma cells]].  Usually develops very slowly with significant fibrous reaction.  Initially effusive then becomes constrictive. Other[[Mycoplasma]] can cause pericarditis is well.
 
'''Purulent:''' [[Pneumococcus]], [[Streptococcus]] and [[Staphylococcus]] are most common.  Also [[Brucellosis]], [[E.coli]], [[Francisella]], [[Haemophilus influenza]], [[Klebsiella]], [[Legionella]](preodominantly by hematogenous spread and approximately 20% by contiguous spread.  Usually these patients are quite ill), [[Meningococci]], [[Neisseria]], [[Proteus]], [[Psuedomonas]], [[Salmonella]], [[Tularemia]].
 
'''Fungal:''' [[Actinomycosis]], [[Amebiasis]], [[Aspergillus]], [[Blastomycosis]], [[Candida]], [[Coccidiomycosis]],[[Echinococcus]], [[Histoplasmosis]], [[Nocardia]], [[Toxoplasmosis]].
 
'''Other:''' [[Borrelia]], [[Lyme disease]] (usually myopericarditis associated with conduction abnormalities). [[Rickettsia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Ankylosing spondylitis]], [[dermatomyositis]], [[polymyositis]], [[Reiter's Syndrome]], [[rheumatoid arthritis]], [[Still's disease]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"|Predominantly [[lung cancer]], [[breast cancer]], [[leukemia]], [[lymphomas]] ([[Hodgkins]] and non-Hodgkins).  Less commonly GI malignancies, [[ovarian cancer]], [[sarcoma]]s and [[melanoma]]s, metastic, hematogenous, [[carcinoma]], [[carcinoid]], [[Sipple syndrome]], [[mesothelioma]], [[fibroma]], [[lipoma]] .  Also [[Kaposis sarcoma]] in [[HIV]] positive patients.
|bgcolor="Beige"| [[Angioma]], [[breast cancer]], [[carcinoid]], [[fibroma]], [[Kaposi's sarcoma]], [[leiomyoma]], [[leukemia]], [[lipoma]], [[lung cancer]], [[lymphoma]], [[melanoma]], [[mesothelioma]], [[cardiac tumors|neoplasia that has spread to the pericardium]], [[ovarian cancer]], [[rhabdomyosarcoma]], [[sarcoma]], [[Sipple syndrome]], [[teratoma]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"|[[Sarcoidosis]]
|bgcolor="Beige"| [[Lung cancer]], [[pneumonia]], [[sarcoidosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
| '''Renal / Electrolyte'''
|bgcolor="Beige"| [[Uremic pericarditis]] is seen in up to 20% of uremic patients requiring chronic [[hemodialysis]].  The mechanism is unknown.  Most commonly there is a small effusion associated with pain and a [[pericardial friction rub]], but there can be a large effusion and present with [[tamponade]]
|bgcolor="Beige"| [[Uremic pericarditis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"|[[Systemic Lupus Erythematosus]] or [[SLE]]: Pericarditis usually occurs in the setting of disease flares (systemic symptoms, high erythrocyte sedimentation rate ([[ESR]]) , +ANA, +dsDNA, [[pleural effusion]]s).  Occurs in 20-40% of patients with [[SLE]] during the course of the disease.  Usually the fluid is serous or grossly bloody.  Analysis of the fluid usually reveals a high protein and low glucose content.  Typically [[WBC]] count is less than 10K, and is made up of primarily [[polymorphonuclear cell]]s ([[PMN]]s). 
|bgcolor="Beige"| [[rheumatic fever|Acute rheumatic fever]], [[amyloidosis]], [[ankylosing spondylitis]], [[Behcet syndrome]], [[Dressler's syndrome]], [[familial mediterranean fever]], [[inflammatory bowel disease]], [[Kawasaki disease]], [[mixed connective tissue disease]], [[polyarteritis nodosa]], [[polymyositis]], [[Reiter's Syndrome]], [[rheumatoid arthritis]], [[sarcoidosis]], [[scleroderma]], [[Still's disease]], [[systemic lupus erythematosus]], [[systemic sclerosis]], [[temporal arteritis]], [[Wegener's granulomatosis]]
 
[[Rheumatoid arthritis]] or [[RA]]: Pericarditis can occur without active joint involvement.  Also serous or bloody.  Usually the protein is > 5 mg/dl, and the glucose is low (<45).  The [[WBC]] is high at 20-90K.  Complement is usually low, and the latex fixation test is usually positive.
 
Other: [[Amyloidosis]], [[Ankylosing Spondylitis]], [[Behcet syndrome]], [[Familial Mediterranian Fever]], [[Mixed Connective Tissue Disease]], [[Polyarteritis nodosa]] [[PAN]], [[Polymyositis]],[[Reiter's Syndrome]], acute [[Rheumatic fever]], [[Sarcoidosis]], [[Scleroderma]], [[Temporal arteritis]] and , [[Wegener's]].
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Sexual'''
| '''Sexual'''
|bgcolor="Beige"| [[Neisseria gonorrhoeae]], [[Treponema pallidum]]
|bgcolor="Beige"| [[Neisseria gonorrhoeae]], [[treponema pallidum]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"|After blunt or penetrating chest trauma
|bgcolor="Beige"| [[chest trauma|Blunt or penetrating chest trauma]], [[esophageal rupture]], [[esophageal rupture|esophogeal perforation]], [[perforation|gastric perforation]], [[Pancreatic fistula|pancreatic-pericardial fistula]]
 
Following cardiovascular procedures such as: cathether ablation for [[arrhythmias]], pacemaker insertion, [[percutaneous coronary intervention]] with either dissection or perforation of the coronary artery, [[TAVI]], thoracic surgery (resulting in [[chylopericardium]], [[valvuloplasty]].
 
Following gastrointestinal catastrophes including [[esophageal rupture]], pancreatic-pericardial fistula, esophogeal perforation, gastric perforation.
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Urologic'''
| '''Urologic'''
|bgcolor="Beige"| [[Renal Failure]], [[Uremia]]
|bgcolor="Beige"| [[Renal failure]], [[uremia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| Commonly the diagnosis is idiopathic.
|bgcolor="Beige"| [[Idiopathic]]
|-
|-
|}
|}


==Differential Diagnosis of Causes of Acute Pericarditis==
===Causes in Alphabetical Order===
In alphabetical order:
*[[5-Fluorouracil]]
 
*[[Actinomycosis]]
*[[Actinomycosis]]
*[[Acute idiopathic pericarditis]]
*[[Acute myocardial infarction]]
*[[Acute rheumatic fever]]
*[[rheumatic fever|Acute rheumatic fever]]
*[[Addisonian crisis]]
*[[Adenovirus]]
*[[Adenovirus]]
*[[Addison's crisis]]
*[[Amebiasis]]
*[[Aminosalicylic acid]]
*[[Amiodarone]]
*[[Amyloidosis]]
*[[Amyloidosis]]
*[[Amebiasis]]
*[[Angioma]]
*[[Ankylosing Spondylitis]]
*[[Ankylosing spondylitis]]
*[[Anticoagulants]]
*[[Aortic dissection]]
*[[Aortic dissection]]
*[[Behcet's Disease]]
*[[Aortic rupture]]
*[[Asbestosis]]
*[[Behcet's disease]]
*[[thoracic duct|Benign obstruction of thoracic duct]]
*[[chest trauma|Blunt or penetrating chest trauma]]
*[[Borrelia]]
*[[Borrelia]]
*[[Breast cancer]]
*[[Breast cancer]]
*[[Bromocriptine]]
*[[Carcinoid]]
*[[Cardiac catheterization]]
*[[Cardiopulmonary resuscitation]]
*[[Catheter ablation|Cathether ablation for arrhythmias]]
*[[Certolizumab pegol]]
*[[Chlamydia psittaci]]
*[[Cholesterol pericarditis]]
*[[Chylopericardium]]
*[[Chylopericardium]]
*[[Coxsackie A]]
*[[Coccidioidomycosis]]
*[[Coxsackie B]]
*[[Collagen vascular disease]]
*[[CABG|Coronary artery bypass grafting]]
*[[Coxsackie B virus]]
*[[Cromolyn sodium]]
*[[Cyclophosphamide]]
*[[Cyclosporine]]
*[[Cytarabine]]
*[[Cytomegalovirus]]
*[[Cytomegalovirus]]
*[[Dantrolene]]
*[[Daunorubicin]]
*[[Dermatomyositis]]
*[[Dermatomyositis]]
*[[Dermatosclerosis]]
*[[Dialysis]]
*[[Dressler's Syndrome]]
*[[Dissecting aortic aneurysm]]
*[[Doxorubicin]]
*[[Dressler's syndrome]]
*[[EBV]]
*[[EBV]]
*[[Echinococcosis]]
*[[ECHO virus]]
*[[ECHO virus]]
*[[Echinococcosis]]
*[[Endocarditis]]
*[[Familial Mediterranian Fever]]
*[[Esophageal rupture]]
*[[esophageal rupture|Esophogeal perforation]]
*[[Familial mediterranean fever]]
*[[Fibroma]]
*[[Francisella]]
*[[Francisella]]
*[[perforation|Gastric perforation]]
*[[Gaucher disease]]
*[[Heart surgery]]
*[[Herpes viruses]]
*[[Histoplasmosis]]
*[[HIV]]
*[[HIV]]
*[[Hydantoin]]
*[[Hydralazine]]
*[[Hypothyroidism]]
*[[Idiopathic]]
*[[Infectious mononucleosis]]
*[[Infectious mononucleosis]]
*[[Inflammatory Bowel Disease]]
*[[Inflammatory bowel disease]]
*[[Influenza virus]]
*[[Influenza virus]]
*[[Isoniazid]]
*[[Jacobsen syndrome|Jacobs arthropathy-camptodactyly syndrome]]
*[[Kaposi's sarcoma]]
*[[Kawasaki disease]]
*[[Leiomyoma]]
*[[Legionella]]
*[[Legionella]]
*[[Leukemia]]
*[[Leukemia]]
*[[Lipoma]]
*[[Lung cancer]]
*[[Lung cancer]]
*[[Lymphoma]]
*[[Lymphoma]]
*[[Melanoma]]
*[[Meningococci]]
*[[Meningococci]]
*[[Mixed Connective Tissue Disease]]
*[[Mesalazine]]
*[[Mesothelioma]]
*[[Methyldopa]]
*[[Methysergide]]
*[[Minoxidil]]
*[[Mixed connective tissue disease]]
*[[Mulibrey nanism|Mulibrey nanism syndrome]]
*[[Mumps virus]]
*[[Mumps virus]]
*[[Mycoplasma infection]]
*[[Mycoplasma]]
*[[Myocardial rupture]]
*[[Myocarditis]]
*[[Myxedema]]
*[[Neisseria gonorrhoeae]]
*[[Neisseria gonorrhoeae]]
*[[Perforated esophagus]]
*[[cardiac tumors|Neoplasia that has spread to the pericardium]],
*[[Ovarian cancer]]
*[[Pacemaker syndrome]]
*[[Pancreatic fistula|Pancreatic-pericardial fistula]]
*[[Penicillin]]
*[[Percutaneous coronary intervention]]
*[[Pergolide]]
*[[Phenylbutazone]]
*[[Pneumococci]]
*[[Pneumococci]]
*[[Polyarteritis Nodosa]]
*[[Pneumonia]]
*[[Polyarteritis nodosa]]
*[[Polymyositis]]
*[[Polymyositis]]
*[[polytetrafluoroethylene|Polytetrafluoroethylene inhalation]]
*[[Postpericardiotomy syndrome]]
*[[Postpericardiotomy syndrome]]
*[[Reiter's Syndrome]]
*[[Practolol]]
*[[Procainamide]]
*[[Radiation therapy]]
*[[Radiation therapy]]
*[[Renal Failure]]
*[[Recurrent hereditary polyserositis]]
*[[Rheumatoid Arthritis]]
*[[Rhabdomyosarcoma]]
*[[Reiter's syndrome]]
*[[Renal failure]]
*[[Reserpine]]
*[[Rheumatoid arthritis]]
*[[Rickettsia]]
*[[Rickettsia]]
*[[Sarcoidosis]]
*[[Sarcoidosis]]
*[[Sarcoma]]
*[[Scleroderma]]
*[[Scleroderma]]
*[[Serum sickness]]
*[[Serum sickness]]
*[[Silicosis]]
*[[Sipple syndrome]]
*[[Staphylococci]]
*[[Staphylococci]]
*[[Streptococci]]
*[[Streptococci]]
*[[Systemic Lupus Erythematosus]]
*[[Streptokinase]]
*[[Streptomycin]]
*[[Sulfa drugs]]
*[[Systemic lupus erythematosus]]
*[[TAVI]]
*[[Temporal arteritis]]
*[[Teratoma]]
*[[Thiazides]]
*[[Thiouracil]]
*[[Thoracic surgery]]
*[[Thorax trauma]]
*[[Thorax trauma]]
*[[Thrombolytics]]
*[[Tocainide]]
*[[Toxoplasmosis]]
*[[Treponema pallidum]]
*[[Treponema pallidum]]
*[[Toxoplasmosis]]
*[[Tuberculosis]]
*[[Tuberculosis]]
*[[Ureaplasma]]
*[[Uremia]]
*[[Uremia]]
*[[Vaccines|Vaccines (smallpox, yellow fever)]]
*[[Valvuloplasty]]
*[[Varicella virus]]
*[[Varicella virus]]
*[[Wegener's granulomatosis]]
*[[Wegener's granulomatosis]]
*[[Whipple's Disease]]
*[[Whipple's Disease]]


==Differential Diagnosis of Causes of Chronic Pericarditis==
=== Summery of causes ===
In alphabetical order:
{{familytree/start |summary=Sample 6}}
{{familytree | | | | | | | | | | | | | | | | | | | | A01 |A01='''Pericarditis classification based on etiology'''}}
{{familytree | | | | | | | | | | |,|-|-|-|-|-|-|-|-|-|^|-|-|-|-|-|-|-|-|-|-|.| | | }}
{{familytree | | | | | | | | | | B01 | | | | | | | | | | | | | | | | | | | B02 | | |B01='''Infectious causes'''|B02='''Non-infectious causes'''}}
{{familytree | | | | | | | | | | |!| | | | | | | | | | | | | | | | | | | | |!| }}
{{familytree | | | | |,|-|-|-|v|-|^|-|v|-|-|-|.| | | |,|-|-|-|-|v|-|-|-|v|-|^|-|v|-|-|-|v|-|-|-|.| }}
{{familytree | | | | |!| | | |!| | | |!| | | |!| | | |!| | | | |!| | | |!| | | |!| | | |!| | | |!| }}
{{familytree | | | | C01 | | C02 | | C03 | | C04 | | C05 | | | C06 | | C07 | | C08 | | C09 | | C10 |C01='''Viral:'''
Enteroviruses(coxsackieviruses, echoviruses)


*[[Amebiasis]]
Herpes viruses(EBV, CMV, HHV-6)
*[[Bacterial infections]]
 
*[[Cholesterol pericarditis]]
Adenoviruses
*[[Chylopericardium]]
 
*[[Coccidioidomycosis]]
Parvovirus B19|C02='''Bacterial:'''
*[[Collagen Vascular Disease]]
Mycobacterium tuberculosis
*[[Coxsackie B]]
 
*[[Echinococcosis]]
Coxiella burnetii
*[[Histoplasmosis]]
 
*[[Neoplastic pericarditis]]
Borrelia burgdorferi|C03='''Fungal:'''
*[[Tuberculosis]]
Histoplasma species
*[[Uremic pericarditis]]
 
Aspergillus species
 
Blastomyces species
 
Candida species|C04='''Parasitic:'''
Echinococcus species
 
Toxoplasma species|C05='''Autoimmune:'''
Systemic autoimmune and auto-inflammatory diseases
 
Systemic vasculitides
 
Sarcoidosis
 
Familial Mediterranean fever
 
IBD
 
Still disease|C06='''Neoplastic:'''
Primary tumours (pericardial mesothelioma)
 
secondary metastatic tumors( lung and breast cancer, lymphoma)|C07='''Metabolic:'''
Uraemia
 
Myxoedema
 
Anorexia nervosa|C08='''Traumatic and Iatrogenic'''|C09='''Drug-related'''|C10='''Others:'''
Amyloidosis
 
Aortic dissection
 
Pulmonary arterial
 
Hypertension
 
Chronic heart failure
 
Congenital absence of the pericardium}}
{{familytree/end}}


==References==
==References==
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[[Category:Medicine]]
[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Up-To-Date]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
[[Category:Differential diagnosis]]
[[Category:Infectious disease]]

Latest revision as of 23:39, 29 July 2020

Pericarditis Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2] Ahmed Zaghw, M.D. [3] Homa Najafi, M.D.[4]

Overview

The causes of pericarditis can be divided into infectious and non-infectious ones. Infectious causes include bacterial, viral, fungal and, parasitic. While, non-infectious causes include autoimmune, neoplastic, metabolic, traumatic and iatrogenic, and drug-related. Acute myocardial infarction, Addisonian crisis, aortic dissection and rupture, blunt or penetrating chest trauma, esophageal perforation, gastric perforation, and myocardial rupture are life threatening causes of pericarditis. Common causes of pericarditis include viral, bacterial organisms, neoplasms, autoimmune and renal failure.

Causes

Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated and include:[1][2][3][4]

Common Causes

Causes by Organ System

Cardiovascular Acute myocardial infarction, aortic rupture, benign obstruction of thoracic duct, dissecting aortic aneurysm, Dresslers syndrome, endocarditis, myocardial rupture, myocarditis
Chemical / poisoning Scombrotoxic fish poisoning
Dermatologic Behcet syndrome
Drug Side Effect Aminosalicylic acid, amiodarone, anticoagulants, bromocriptine, cromolyn sodium, certolizumab pegol, cyclosporine, cyclophosphamide, cytarabine, dantrolene, daunorubicin, doxorubicin, Doxycycline, 5-fluorouracil, hydantoin, hydralazine, isoniazid, mesalazine, methyldopa, methysergide, minoxidil, Olsalazine, penicillin, Pergolide, phenylbutazone, practolol, pramipexole, procainamide, procainamide, reserpine, ropinirole, streptokinase, streptomycin, sulfa drugs, Thalidomide, thiazides, thiouracil, thrombolytics, tocainide
Ear Nose Throat Temporal arteritis
Endocrine Addisonian crisis, hypothyroidism, myxedema
Environmental Asbestosis, polytetrafluoroethylene inhalation, silicosis
Gastroenterologic Inflammatory bowel disease, Whipple's disease
Genetic Gaucher disease, Jacobs arthropathy-camptodactyly syndrome, Mulibrey nanism syndrome, recurrent hereditary polyserositis
Hematologic Leukemia, lymphoma
Iatrogenic Cardiac catheterization, cardiopulmonary resuscitation, cathether ablation for arrhythmias, coronary artery bypass grafting, dialysis, heart surgery, pacemaker syndrome, percutaneous coronary intervention, postpericardiotomy syndrome, radiation therapy, TAVI, thoracic surgery, vaccines (smallpox, yellow fever), valvuloplasty
Infectious Disease Actinomycosis, adenovirus, alveolar hydatid disease, amebiasis, aspergillus, blastomycosis, borrelia, brucellosis, candida, chlamydia psittaci, coccidiomycosis, coxsackie B virus, cytomegalovirus, E.coli, EBV, echinococcus, ECHO virus, entamoeba histolytica, francisella, haemophilus influenza, hepatitis B, herpes viruses, histoplasmosis, HIV, infectious mononucleosis, influenza, klebsiella, legionella, Lyme disease, meningococci, mumps, mycobacterium tuberculosis, mycoplasma, neisseria, nocardia, pneumococcus, proteus, pseudomonas, rickettsia, salmonella, staphylococcus, streptococcus, toxoplasmosis, tularemia, ureaplasma, varicella
Musculoskeletal / Ortho Ankylosing spondylitis, dermatomyositis, polymyositis, Reiter's Syndrome, rheumatoid arthritis, Still's disease
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Angioma, breast cancer, carcinoid, fibroma, Kaposi's sarcoma, leiomyoma, leukemia, lipoma, lung cancer, lymphoma, melanoma, mesothelioma, neoplasia that has spread to the pericardium, ovarian cancer, rhabdomyosarcoma, sarcoma, Sipple syndrome, teratoma
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Lung cancer, pneumonia, sarcoidosis
Renal / Electrolyte Uremic pericarditis
Rheum / Immune / Allergy Acute rheumatic fever, amyloidosis, ankylosing spondylitis, Behcet syndrome, Dressler's syndrome, familial mediterranean fever, inflammatory bowel disease, Kawasaki disease, mixed connective tissue disease, polyarteritis nodosa, polymyositis, Reiter's Syndrome, rheumatoid arthritis, sarcoidosis, scleroderma, Still's disease, systemic lupus erythematosus, systemic sclerosis, temporal arteritis, Wegener's granulomatosis
Sexual Neisseria gonorrhoeae, treponema pallidum
Trauma Blunt or penetrating chest trauma, esophageal rupture, esophogeal perforation, gastric perforation, pancreatic-pericardial fistula
Urologic Renal failure, uremia
Miscellaneous Idiopathic

Causes in Alphabetical Order

Summery of causes

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Pericarditis classification based on etiology
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Infectious causes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Non-infectious causes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Viral:

Enteroviruses(coxsackieviruses, echoviruses)

Herpes viruses(EBV, CMV, HHV-6)

Adenoviruses

Parvovirus B19
 
Bacterial:

Mycobacterium tuberculosis

Coxiella burnetii

Borrelia burgdorferi
 
Fungal:

Histoplasma species

Aspergillus species

Blastomyces species

Candida species
 
Parasitic:

Echinococcus species

Toxoplasma species
 
Autoimmune:

Systemic autoimmune and auto-inflammatory diseases

Systemic vasculitides

Sarcoidosis

Familial Mediterranean fever

IBD

Still disease
 
 
Neoplastic:

Primary tumours (pericardial mesothelioma)

secondary metastatic tumors( lung and breast cancer, lymphoma)
 
Metabolic:

Uraemia

Myxoedema

Anorexia nervosa
 
Traumatic and Iatrogenic
 
Drug-related
 
Others:

Amyloidosis

Aortic dissection

Pulmonary arterial

Hypertension

Chronic heart failure

Congenital absence of the pericardium

References

  1. ↑ Imazio, Massimo (2012). "Contemporary management of pericardial diseases". Current Opinion in Cardiology. 27 (3): 308–317. doi:10.1097/HCO.0b013e3283524fbe. ISSN 0268-4705.
  2. ↑ Imazio, Massimo; Spodick, David H.; Brucato, Antonio; Trinchero, Rita; Adler, Yehuda (2010). "Controversial Issues in the Management of Pericardial Diseases". Circulation. 121 (7): 916–928. doi:10.1161/CIRCULATIONAHA.108.844753. ISSN 0009-7322.
  3. ↑ Imazio, Massimo; Brucato, Antonio; DeRosa, Francesco Giuseppe; Lestuzzi, Chiara; Bombana, Enrico; Scipione, Federica; Leuzzi, Stefano; Cecchi, Enrico; Trinchero, Rita; Adler, Yehuda (2009). "Aetiological diagnosis in acute and recurrent pericarditis: when and how". Journal of Cardiovascular Medicine. 10 (3): 217–230. doi:10.2459/JCM.0b013e328322f9b1. ISSN 1558-2027.
  4. ↑ Sliwa, Karen; Mocumbi, Ana Olga (2009). "Forgotten cardiovascular diseases in Africa". Clinical Research in Cardiology. 99 (2): 65–74. doi:10.1007/s00392-009-0094-1. ISSN 1861-0684.

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