Pericarditis causes: Difference between revisions

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|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.
|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]].
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| '''Miscellaneous'''
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|bgcolor="Beige"|[[Amyloidosis]]
|bgcolor="Beige"|[[Amyloidosis]], commonly the diagnosis is idiopathic.
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Revision as of 14:21, 16 July 2011

Pericarditis Microchapters

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Overview

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HIV
Post MI
Dressler's syndrome
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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).

Common Causes of Pericarditis [1]


Complete Differential Diagnosis of the Causes of Pericarditis

(By organ system)

Cardiovascular Post-MI (Dresslers), Dissecting aortic aneurysm
Chemical / poisoning No underlying causes
Dermatologic Behcet syndrome
Drug Side Effect Usually associated with small effusions. Common culprits include hydralazine, procainamide, DOH, isoniazid, phenylbutazone, dantrolene, doxorubicin, methylsergide, penicillin.
Ear Nose Throat Temporal arteritis
Endocrine Usually in conjunction with clinically severe hypothyroidism. Most early case reports associated with myxedema and patients also had ascites, pleural effusions and uveal edema. Often resolves with thyroid replacement therapy. A pericardial effusion can be seen as part of an Addisonian crisis.
Environmental No underlying causes
Gastroenterologic Inflammatory bowel disease, Whipple's
Genetic No underlying causes
Hematologic Leukemia, Lymphoma
Iatrogenic Post-pericardiotomy syndrome,Radiation therapy, Chylopericardium (from thoracic duct obstruction secondary to tumor, surgical procedure.
Infectious Disease *Viral: Coxsackie B Virus, Echovirus, Adenovirus (less commonly: Mumps, Influenza, varicella, Hepatitis B and CMV-especially in HIV patients.) Usually associated with a viral prodrome and acute pericarditis.
Musculoskeletal / Ortho No underlying causes
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Predominantly lung, breast, leukemia, lymphomas (Hodgkins and non-Hodgkins). Less commonly GI malignancies, ovarian cancer, sarcomas and melanomas, metastic, hematogenous, carcinoma, carcinoid, Sipple syndrome, mesothelioma, fibroma, lipoma . Also Kaposis sarcoma in HIV positive patients.
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Sarcoidosis
Renal / Electrolyte 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
Rheum / Immune / Allergy *Systemic Lupus Erythematosus or SLE: Pericarditis usually occurs in the setting of disease flares (systemic symptoms, high erythrocyte sedimentation rate (ESR) , +ANA, +dsDNA, pleural effusions). 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 cells (PMNs).
Sexual No underlying causes
Trauma After chest trauma, throacic surgery, PCM insertion, Valvuloplasty. Also from esophageal rupture, pancreatic-pericardial fistula (check amylase), penetrating chest injury, esophogeal perforation, gastric perforation, during catheterization (pacemaker insertion, cathether ablation for arrhythmias, diagnostic, PCI with coronary dissection).
Urologic No underlying causes
Miscellaneous Amyloidosis, commonly the diagnosis is idiopathic.

Differential Diagnosis of Causes of Acute Pericarditis

In alphabetical order:

Differential Diagnosis of Causes of Chronic Pericarditis

In alphabetical order:

References

  1. ↑ Maisch B, Ristic AD (2002). "The classification of pericardial disease in the age of modern medicine". Curr Cardiol Rep. 4 (1): 13–21. doi:10.1007/s11886-002-0121-6. PMID 11743917.

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