Pericardial effusion causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Mugilan Poongkunran M.B.B.S [2]; Cafer Zorkun, M.D., Ph.D. [3]; Varun Kumar, M.B.B.S.;

Overview

Pericardial effusion can be classified into serous, bloody and chylous effusions based on the composition of the effusion fluid. Infections and inflammation usually cause serous effusion while bloody effusions are as a result of trauma to the heart. Though iatrogenic causes and infections are the common etiologies, pericardial disease may also be a feature of other disorders such as inflammatory bowel disease. Aortic dissection or free wall rupture should also be considered in patients with unstable hemodynamics and pericardial tamponade.

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
• Aortic dissection
• Aortic rupture
• Myocardial rupture
• Rupture of ventricular aneurysm
• Uremic pericarditis

Common Causes

• Acute myocardial infarction
• Aortic dissection
• Aortic rupture
• Bacterial pericarditis
• Cardiac catheterization
• Cardiomyopathy
• Chemotherapy
• Chest trauma
• Collagen vascular disease
• Congestive heart failure
• Dressler's syndrome
• Neoplasm
• Postpericardiotomy syndrome
• Postirradiation
• Rheumatic pericarditis
• Tuberculous pericarditis
• Uremic pericarditis
• Viral pericarditis

Causes by Organ System

Cardiovascular	Acute myocardial infarction, aortic dissection, aortic rupture, bacterial pericarditis, benign obstruction of thoracic duct, Cantu syndrome, capillary leak syndrome, cardiomyopathy, congestive heart failure, constrictive pericarditis, dilated cardiomyopathy, dissecting aortic aneurysm, Dressler's syndrome, hypersensitivity pericarditis with eosinophilia, hypertrichotic osteochondrodysplasia, Kawasaki disease, myocardial rupture, heart surgery, fungal pericarditis, pyogenic pericarditis, rheumatic pericarditis, tuberculous pericarditis, uremic pericarditis, ventricular aneurysm, viral pericarditis
Chemical / poisoning	Asbestosis, silicosis
Dermatologic	Behcet syndrome, Cantu syndrome, hypertrichotic osteochondrodysplasia
Drug Side Effect	Anticoagulants, bleomycin, chemotherapy, Cyclophosphamide, dantrolene, daunorubicin, doxorubicin, hydralazine, isoniazid, minoxidil, penicillin, phenylbutazone, phenytoin, procainamide
Ear Nose Throat	Temporal arteritis
Endocrine	Addisonian crisis, hypothyroidism, myxedema
Environmental	No underlying causes
Gastroenterologic	Acute pancreatitis, cirrhosis, inflammatory bowel disease, Whipple's
Genetic	Cantu syndrome, congenital disorders of glycosylation, Gaucher disease, hypertrichotic osteochondrodysplasia, Jacobs arthropathy-camptodactyly syndrome, Mulibrey nanism syndrome, recurrent hereditary polyserositis
Hematologic	Coagulopathy, leukemia, lymphoma
Iatrogenic	Cardiac catheterization, cardiopulmonary resuscitation, cathether ablation for arrhythmias, coronary artery bypass grafting, dialysis, heart surgery, percutaneous coronary intervention, postpericardiotomy syndrome, radiation, TAVI, thoracic surgery, valvuloplasty
Infectious Disease	Actinomycosis, adenovirus, alveolar hydatid disease, amebiasis, aspergillus, blastomycosis, borrelia, brucellosis, candida, coccidiomycosis, coxsackie B Virus, cytomegalovirus, Ebstein-Barr virus, echinococcus, echovirus, entamoeba histolytica, escherichia coli, francisella, fungal pericarditis, haemophilus influenza, hepatitis B, histoplasmosis, influenza, klebsiella, legionella, Lyme disease, meningococci, mumps, mycobacterium tuberculosis, mycoplasma pnuemonia, neisseria, nocardia, pneumococci, pneumonia, proteus, pseudomonas, pyogenic pericarditis, rheumatic fever, rickettsia, salmonella, scrub typhus, staphylococcus, streptococci, syphilis, toxoplasmosis, tuberculous pericarditis, tularemia, varicella, viral pericarditis
Musculoskeletal / Ortho	Cantu syndrome, hypertrichotic osteochondrodysplasia
Neurologic	No underlying causes
Nutritional / Metabolic	Malnutrition, congenital disorders of glycosylation
Obstetric/Gynecologic	Ovarian hyperstimulation syndrome
Oncologic	Breast cancer, carcinoid, fibroma, Kaposi's sarcoma, leukemia, lung cancer, lymphoma, melanoma, mesothelioma, neoplasia that has spread to the pericardium, ovarian cancer, sarcoma, Sipple syndrome
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Bronchogenic cyst, lung cancer, pneumonia, sarcoidosis
Renal / Electrolyte	Nephrotic syndrome, renal failure, uremic pericarditis
Rheum / Immune / Allergy	Acute rheumatic fever, amyloidosis, ankylosing spondylitis, Behcet syndrome, collagen vascular disease, Dressler's syndrome, inflammatory bowel disease, Kawasaki disease, mixed connective tissue disease, polyarteritis nodosa, polymyositis, Reiter's syndrome, rheumatic pericarditis, rheumatoid arthritis, sarcoidosis, scleroderma, Still's disease, systemic lupus erythematosus, systemic sclerosis, temporal arteritis, Wegener's
Sexual	Neisseria gonorrhoeae, treponema pallidum
Trauma	Blunt or penetrating chest trauma, esophageal rupture, esophogeal perforation, gastric perforation, pancreatic-pericardial fistula
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Hypoalbuminemia, idiopathic, radiation

Causes in Alphabetical Order

Actinomycosis Acute myocardial infarction Acute pancreatitis Acute rheumatic fever Addisonian crisis Adenovirus Alveolar hydatid disease Amebiasis Amyloidosis Ankylosing spondylitis Anticoagulants Aortic dissection Aortic rupture Asbestosis Aspergillus Bacterial pericarditis Behcet syndrome Benign obstruction of thoracic duct Blastomycosis Blunt or penetrating chest trauma Borrelia Breast cancer Bronchogenic cyst Brucellosis Candida Cantu syndrome Capillary leak syndrome Carcinoid Cardiac catheterization Cardiomyopathy Chemotherapy Chest trauma Cirrhosis of liver Coagulopathy Coccidiomycosis Collagen vascular disease Congenital disorders of glycosylation Congestive heart failure Constrictive pericarditis Coronary artery bypass grafting Coxsackie B Virus Cytomegalovirus Dantrolene Daunorubicin Dialysis Dilated cardiomyopathy Dissecting aortic aneurysm Doxorubicin Dressler's syndrome Ebstein-Barr virus Echinococcus Echovirus

Entamoeba histolytica Escherichia coli Esophageal rupture Esophogeal perforation Fibroma Francisella Fungal pericarditis Gastric perforation Gaucher disease Haemophilus influenza Heart surgery Hepatitis B Histoplasmosis Hydralazine Hypersensitivity pericarditis with eosinophilia Hypertrichotic osteochondrodysplasia Hypoalbuminemia Hypothyroidism Idiopathic Infection Inflammatory bowel disease Influenza Isoniazid Jacobs arthropathy-camptodactyly syndrome Kaposi sarcoma Kaposi's sarcoma Kawasaki disease Klebsiella Legionella Leukemia Lung cancer Lupus Lyme disease Lymphoma Malnutrition Melanoma Meningococci Mesothelioma Minoxidil Mixed connective tissue disease Mulibrey nanism syndrome Mumps Mycobacterium tuberculosis Mycoplasma pnuemonia Myocardial rupture Myxedema Neisseria Neoplasia that has spread to the pericardium Nephrotic syndrome Nocardia Ovarian cancer Ovarian hyperstimulation syndrome

Pancreatic-pericardial fistula Penicillin Percutaneous interventional procedures Pericarditis Phenylbutazone Phenytoin Pneumococci Pneumonia Polyarteritis nodosa Polymyositis Postirradiation Postpericardiotomy syndrome Procainamide Proteus Pseudomonas Pyogenic pericarditis Radiation Recurrent hereditary polyserositis Reiter's syndrome Renal failure Rheumatic fever Rheumatic pericarditis Rheumatoid arthritis Rickettsia Salmonella Sarcoidosis Sarcoma Scleroderma Scorpion sting Scrub typhus Silicosis Sipple syndrome Staphylococcus Still's disease Streptococci Syphilis Systemic lupus erythematosus Systemic sclerosis TAVI Temporal arteritis Thoracic surgery Toxoplasmosis Treponema pallidum Tuberculous pericarditis Tularemia Uremic pericarditis Valvuloplasty Varicella Ventricular aneurysm Viral pericarditis Wegener's Whipple's

References

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