Pericarditis overview

Pericarditis Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
HIV
Post MI
Dressler's syndrome
Post-pericardiotomy
Radiation
Tuberculosis
Uremia
Malignancy
Differentiating Pericarditis from other Diseases
Epidemiology and Demographics
Screening
Natural History, Complications and Prognosis
Pericardial Effusion
Cardiac Tamponade
Constrictive Pericarditis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Pericardiocentesis
Pericardial Window
Pericardial Stripping
Treatment Related Videos
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Pericarditis overview On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Google Images
American Roentgen Ray Society Images of Pericarditis overview All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Pericarditis overview
CDC on Pericarditis overview
Pericarditis overview in the news
Blogs on Pericarditis overview
Directions to Hospitals Treating Type page name here
Risk calculators and risk factors for Pericarditis overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Pericarditis is a condition in which the sac-like covering surrounding the heart (the pericardium) becomes inflamed. Symptoms of pericarditis include chest pain which increases with deep breathing and lying flat.

Epidemiology and Demographics

Pericarditis most often affects men aged 20 - 50. It usually follows respiratory infections. Pericarditis in developed countries are usually due to viral infections such as echovirus and coxsackie virus, while in developing countries it is usually secondary to tuberculosis or HIV infection. The incidence of pericarditis following MI has greatly reduced with the use of early thrombolytic agents and revascularization.

Natural History, Complications and Prognosis

Pericarditis is often self-limited and most people recover in 2 weeks to 3 months. However, the condition can be complicated by significant fluid buildup around the heart (a pericardial effusion or cardiac tamponade) and may require urgent intervention including pericardiocentesis. If scarring of the sac around the heart (the pericardium) occurs, then this is called constrictive pericarditis which may require surgical stripping of the scar.

Causes

Pericarditis is usually a complication of viral infections, most commonly echovirus or coxsackie virus. In addition, pericarditis can be associated with diseases such as autoimmune disorders, cancer, hypothyroidism, and kidney failure. Often the cause of pericarditis remains unknown, or idiopathic.

Diagnosis

Physical Examination

A careful physical examination must be performed to exclude the presence of cardiac tamponade, a dangerous complication of pericarditis. If cardiac tamponade is present, then pulsus paradoxus, hypotension, an elevated jugular venous pressure and peripheral edema may be present.

ECG

In the presence of a large effusion or tamponade, there may be diminished voltage and electrical alternans (alternation of QRS complex amplitude or axis between beats).

Echocardiography

Echocardiographys is generally performed to assess for the presence of a pericardial effusion and to assess and monitor its size. Echocardiography is critical in confirming the clinical suspicion cardiac tamponade.

Treatment

In cases that are thought to be due to viral pericarditis, treatment includes aspirin or a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen for inflammation of the pericardium. Corticosteroids such as prednisone and / or Colchicine may be be necessary in refractory cases. Diuretics may be prescribed to remove excess fluid in the pericardial sac.