What are the infectious causes of pericarditis?

Written by Tang Li

Cardiology

Updated on September 07, 2024

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The causes of pericarditis include the following types: first, acute nonspecific; second, tumors; third, autoimmune disorders; fourth, metabolic diseases; fifth, physical factors such as trauma and radiation; sixth, diseases of adjacent organs and tissues, such as acute myocardial infarction, pleurisy, aortic dissection, pulmonary embolism, etc. The infectious causes of acute pericarditis mainly include viruses, bacteria, fungi, parasites, and rickettsiae. Common types of pericarditis include tuberculous pericarditis and purulent pericarditis.

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Written by Li Hai Wen

Cardiology

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Symptoms of Acute Pericarditis

Acute pericarditis is not a common disease in daily life. What symptoms or clinical manifestations will appear after someone develops acute pericarditis? The clinical manifestations are mainly reflected in the following aspects: First, patients often experience chest pain and shortness of breath, and this pain often has a certain relationship with breathing. Second, the electrocardiogram often shows changes with ST segment elevation. Third, during a physical examination, doctors can often hear pericardial friction rub, or may feel the sensation of pericardial friction. Based on these symptoms and signs, doctors often make a diagnosis of acute pericarditis.

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Written by Han Shun Li

Pulmonology

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What causes constrictive pericarditis?

Constrictive pericarditis refers to the fibrosis or calcification of the pericardium, which restricts the filling of the ventricles during diastole and leads to a series of symptoms. What causes constrictive pericarditis? Generally, constrictive pericarditis is secondary to acute pericarditis. In our country, the most common cause of constrictive pericarditis is tuberculous pericarditis, followed by purulent or traumatic pericarditis. A minority of constrictive pericarditis cases may be associated with tumors of the pericardium, acute nonspecific pericarditis, and radiation-induced pericarditis, among others. Of course, some patients have idiopathic constrictive pericarditis.

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Written by Liu Ying

Cardiology

1min 8sec

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What are the symptoms of acute pericarditis?

Acute pericarditis is an acute inflammatory disease of the visceral and parietal layers of the pericardium. The most common causes are viral infections and bacterial infections, but autoimmune diseases and uremia can also cause acute pericarditis. Characteristic pain behind the sternum or in the precordial area is common during the fibrinous exudative phase of the inflammation. This pain is associated with respiratory movements and often worsens with coughing, deep breathing, changes in body position, or swallowing. The nature of the pain is very sharp and can radiate to the neck, left shoulder, left arm, or even the upper abdomen. As the condition progresses, symptoms can shift from the fibrinous phase pain to dyspnea during the exudative phase. Some patients may develop significant pericardial effusion, leading to cardiac tamponade, and subsequently exhibit a range of related symptoms, including dyspnea and edema.

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Written by Tang Li

Cardiology

1min 34sec

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What are the clinical considerations for acute pericarditis?

The treatment and prognosis of acute pericarditis mainly depend on the cause, and are also related to whether it is diagnosed and treated correctly early on. For various types of pericarditis, if constrictive syndrome occurs, pericardiocentesis should be performed immediately to relieve symptoms. In cases like tuberculous pericarditis, if not treated aggressively, it can usually progress to chronic constrictive pericarditis. Acute nonspecific pericarditis and post-cardiac injury syndrome may lead to recurrent attacks of pericarditis after the initial episode, known as recurrent pericarditis, with an incidence rate of about 20%-30%. This is one of the most difficult complications of acute pericarditis to manage. Clinically, it generally presents similar to acute pericarditis, with recurrent attacks months or years after the initial episode, accompanied by severe chest pain. Most patients should be treated again with high doses of non-steroidal anti-inflammatory drugs, slowly tapering over several months until the medication can be stopped. If ineffective, corticosteroid treatment may be administered; in severe cases, intravenous methylprednisolone may be given, and symptoms in most patients may improve within a few days. However, it is important to note that symptoms often reappear during steroid tapering.

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Written by Liu Ying

Cardiology

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Treatment of constrictive pericarditis

Constrictive pericarditis refers to a disease in which the heart is surrounded by a densely thickened fibrotic or calcified pericardium, restricting ventricular diastolic filling and producing a series of circulatory disorders, typically chronic in nature. In China, the most common cause of constrictive pericarditis is tuberculosis. Constrictive pericarditis is a progressive disease, and most patients will develop chronic constrictive pericarditis. At this stage, pericardiectomy is the only effective treatment method. It should be performed early to avoid complications such as cardiac cachexia, severe liver dysfunction, and myocardial atrophy, with surgery usually carried out after controlling the pericardial infection. For tuberculosis patients, anti-tuberculosis treatment should continue for one year after surgery.