Pericarditis epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.
Overview
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.
Age
Pericarditis is more frequently seen among adolescents than young adults or children. However, no differences in etiology, clinical course, and prognosis were observed across different age groups of patients with moderate or large pericardial effusions.[1]
Gender
Pericarditis is seen more frequently among males than females.
Developed Countries
Pericarditis in developed countries is most often of viral origin.[2][3][4] Pericarditis most often affects men aged 20 - 50. It usually follows respiratory infections, most commonly echovirus or coxsackie virus. In children, it is most commonly caused by adenovirus or coxsackie virus. The incidence and prevalence of viral pericarditis varies with season and region.
Developing Countries
In developing countries pericarditis is usually secondary to tuberculosis or HIV infection.[5] Tuberculous pericarditis, caused by Mycobacterium tuberculosis, is found in approximately 1% of all autopsied cases of TB and in 1% to 2% of instances of pulmonary TB.[6] It accounted for 69.5% (162 of 233) of cases referred for diagnostic pericardiocentesis in a study in Western Cape Province of South Africa,[7] while the same accounts for 4% of cases in developed countries.[8]
Disorders Associated with Pericarditis
Pericarditis can be associated with diseases such as autoimmune disorders, cancer, hypothyroidism, and kidney failure. It occurs in approximately 13% of patients who are on maintenance hemodialysis.[9] Hyperuricemia due to inadequate dialysis or fluid overload may be the reason for pericarditis.[10]
Pericarditis Following Myocardial Infarction
In one series, about 1% of STEMI patients presenting to emergency department were seen to have pericarditis[11]. The use of thrombolytic agents and early revascularization have greatly reduced the incidence of both early postinfarction pericarditis and Dressler's syndrome. Patients presenting to the emergency department with pericarditis account for up to 5% of those with nonischemic chest pain[12].
References
- ↑ Mercé J, Sagristà Sauleda J, Permanyer Miralda G, Carballo J, Olona M, Soler Soler J (2000). "[Pericardial effusion in the elderly: A different disease?]". Rev Esp Cardiol. 53 (11): 1432–6. PMID 11084000.
- ↑ Troughton RW, Asher CR, Klein AL (2004). "Pericarditis". Lancet. 363 (9410): 717–27. doi:10.1016/S0140-6736(04)15648-1. PMID 15001332.
- ↑ Little WC, Freeman GL (2006). "Pericardial disease". Circulation. 113 (12): 1622–32. doi:10.1161/CIRCULATIONAHA.105.561514. PMID 16567581.
- ↑ Imazio M, Brucato A, Adler Y, Brambilla G, Artom G, Cecchi E; et al. (2007). "Prognosis of idiopathic recurrent pericarditis as determined from previously published reports". Am J Cardiol. 100 (6): 1026–8. doi:10.1016/j.amjcard.2007.04.047. PMID 17826391.
- ↑ Chen Y, Brennessel D, Walters J, Johnson M, Rosner F, Raza M (1999). "Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature". Am Heart J. 137 (3): 516–21. PMID 10047635.
- ↑ Fowler NO (1991). "Tuberculous pericarditis". JAMA. 266 (1): 99–103. PMID 2046135.
- ↑ Reuter H, Burgess LJ, Doubell AF (2005). "Epidemiology of pericardial effusions at a large academic hospital in South Africa". Epidemiol Infect. 133 (3): 393–9. PMC 2870262. PMID 15962545.
- ↑ Sagristà-Sauleda J, Permanyer-Miralda G, Soler-Soler J (1988). "Tuberculous pericarditis: ten year experience with a prospective protocol for diagnosis and treatment". J Am Coll Cardiol. 11 (4): 724–8. PMID 3351140.
- ↑ Rutsky EA, Rostand SG (1987). "Treatment of uremic pericarditis and pericardial effusion". Am J Kidney Dis. 10 (1): 2–8. PMID 3605080.
- ↑ Lundin, AP. Recurrent uremic pericarditis: A marker of inadequate dialysis. Semin Dial 1990; 3:5.
- ↑ Brady WJ, Perron AD, Martin ML, Beagle C, Aufderheide TP (2001). "Cause of ST segment abnormality in ED chest pain patients". Am J Emerg Med. 19 (1): 25–8. doi:10.1053/ajem.2001.18029. PMID 11146012.
- ↑ Spodick DH (2003). "Acute cardiac tamponade". N Engl J Med. 349 (7): 684–90. doi:10.1056/NEJMra022643. PMID 12917306.