Pericarditis causes

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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

Life threatening causes of pericarditis include acute myocardial infarction, Addisonian crisis, aortic dissection and rupture, blunt or penetrating chest trauma, esophageal perforation, gastric perforation, and myocardial rupture. Common causes of pericarditis include viruses, bacteria, neoplasms, 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.

• Acute myocardial infarction
• Addisonian crisis
• Aortic dissection
• Aortic rupture
• Blunt or penetrating chest trauma
• Esophogeal perforation
• Gastric perforation
• Myocardial rupture

Common Causes

• Acute myocardial infarction
• Cardiac catheterization
• Staphylococcus aureus (MSSA, MRSA)
• Streptococcus pneumoniae
• Neisseria meningitidis
• Enterobacteriaceae
• Tuberculosis
• Histoplasmosis
• Coxsackie B virus
• Echovirus
• HIV
• Adenovirus
• Influenza
• Neoplasm
• Renal Failure
• Sulfa drugs
• Aminosalicylic acid
• Amiodarone
• Systemic lupus erythematosus
• Rheumatoid arthritis
• Idiopathic

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

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

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