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 Tang Li

Cardiology

1min 12sec

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What are the clinical considerations for acute pericarditis?

The treatment and prognosis of acute pericarditis depend on the cause, as well as early diagnosis and correct treatment. For various types of pericarditis, such as those presenting with tamponade syndrome, pericardiocentesis should be performed to relieve symptoms. Tuberculous pericarditis, if not actively treated, can evolve into chronic constrictive pericarditis. Patients with acute nonspecific pericarditis and post-cardiac injury syndrome may experience recurrent pericarditis after their initial episode, which is the most challenging complication of acute pericarditis. Clinically, it presents similarly to acute pericarditis, with recurrent episodes months to years after the initial onset, accompanied by severe chest pain. Most patients can be treated again with high doses of non-steroidal anti-inflammatory drugs, slowly tapering to normal over several months. If ineffective, corticosteroid therapy may be administered. (Medications should be used under the guidance of a doctor according to specific circumstances.)

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Written by Liu Ying

Cardiology

1min 1sec

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Symptoms of acute pericarditis

Acute pericarditis is an acute inflammatory disease of the visceral and parietal layers of the pericardium, with the most common cause being viral infections. The hallmark of acute pericarditis is pain in the precardiac area behind the sternum. The nature of the pain is very sharp, typically occurring during the fibrinous exudation phase of inflammatory changes, caused by friction between the visceral and parietal layers of the pericardium. The pain can radiate to the neck, left shoulder, and even the upper abdomen. It is associated with respiratory movements and often worsens with coughing, deep breathing, or changing body positions. When fluid exudes into the pericardium, separating the visceral and parietal layers, the patient's pain may decrease or disappear. However, some patients may experience symptoms such as breathing difficulties and edema due to cardiac tamponade.

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Written by Liu Ying

Cardiology

42sec

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Early symptoms of acute pericarditis

The early symptoms of acute pericarditis are pain, which is located behind the sternum or in the precordial area, typically seen in the fibrin exudative type of inflammation. This pain arises from the friction between the visceral pericardium and the parietal pericardium. The nature of the pain is very sharp and related to respiratory movement, commonly exacerbated by coughing, deep breathing, or swallowing. The pain can radiate to the neck, left shoulder, and left arm. As fluid accumulates in the pericardium and the two layers of the pericardium separate, the pain may decrease or disappear.

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Written by Xiong Hong Hai

Infectious Disease

40sec

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Tuberculous pericarditis differential diagnosis

The differential diagnosis of tuberculous pericarditis requires differentiation from other types of pericardial inflammation, such as bacterial pericarditis and nonspecific infections that lead to cellular inflammation of the pericardium. In addition to infections that can cause pericarditis, other infectious diseases such as subacute endocarditis and infections caused by other microbes can also lead to pericarditis. Furthermore, some rheumatic autoimmune diseases can also present with pericarditis. It is necessary to perform pericardiocentesis and fluid examination to determine the specific cause.

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Written by Liu Yong

Cardiology

56sec

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Constrictive pericarditis causes hepatomegaly.

The so-called constrictive pericarditis refers to the presence of fibrotic calcifications and fibrotic hyperplasia in the pericardium, which severely affects the diastolic function of the heart. Once the diastolic function of the heart is compromised, the return flow of venous blood becomes severely obstructed, leading to congestion of the liver. Therefore, once congestion of the liver and spleen occurs, enlargement of the liver can occur, and in severe cases, it can lead to systemic edema, including ascites and similar conditions. Thus, the basic principle behind the enlargement of the liver in constrictive pericarditis is as such. Especially in such cases, patients will experience severe dietary problems, including poor appetite and indigestion, which further lead to low protein levels and malnutrition, exacerbating the enlargement of the liver and edema.