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 Xiong Hong Hai
Infectious Disease
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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 Li Hai Wen
Cardiology
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Is pericarditis serious?

Pericarditis refers to a group of diseases mainly characterized by inflammation and effusion of the pericardium. The severity of pericarditis depends on the condition of the disease. Firstly, if the inflammation and effusion of the pericardium are not severe, patients often experience symptoms such as chest tightness or chest pain. In general, this type of pericarditis is not considered severe. Secondly, if the inflammation and effusion of the pericardium are more pronounced, it can lead to pericardial effusion, especially in cases of large amounts of pericardial fluid. At this time, the condition is often quite serious, and it is essential to undergo formal treatment under the guidance of a doctor, including pericardial drainage therapy.

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Written by Tang Li
Cardiology
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What are the symptoms of pericarditis?

Fibrinous pericarditis is primarily characterized by precordial pain, similar to that seen in acute nonspecific pericarditis and infectious pericarditis. Tuberculous or neoplastic pericarditis that develops slowly may not show obvious pain symptoms. The nature of the pain can be sharp and related to respiratory movements. It is often exacerbated by coughing, deep breathing, changing body position, or swallowing. The pain is located in the precordial area and may radiate to the neck, left shoulder, left arm, and left scapula, and can also reach the upper abdomen. The pain can be compressive and located behind the sternum. The most prominent symptom of exudative pericarditis is dyspnea, which may be associated with bronchopulmonary compression and pulmonary congestion. In severe cases of dyspnea, the patient may sit up to breathe, leaning forward, with rapid and shallow breathing and pale complexion. There may be hepatomegaly, as well as compression of the trachea and esophagus causing dry cough, hoarseness, and difficulty swallowing. Rapid pericardial effusion can lead to acute cardiac tamponade, presenting with significant tachycardia and decreased blood pressure. Reduced pulse pressure and increased venous pressure, if the cardiac output significantly drops, can lead to shock. If the fluid accumulates slowly, it could lead to subacute or chronic cardiac tamponade, characterized by systemic venous congestion and distended jugular veins.

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Written by Chen Tian Hua
Cardiology
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How is acute pericarditis classified?

Acute pericarditis is classified according to the course of the disease, including acute fibrinous pericarditis and acute exudative pericarditis. If classified according to the cause, it can be divided into infectious pericarditis and non-infectious pericarditis. Infectious pericarditis can be caused by viruses, bacteria, tuberculosis, fungi, etc., while non-infectious pericarditis can be seen in tumors, uremia, acute myocardial infarction, aortic dissection, connective tissue disease, trauma, and cardiac surgery, etc. Acute pericarditis is an acute inflammatory disease of the pericardium's parietal layer, and its occurrence requires timely diagnosis. It is also important to further clarify the specific cause of acute pericarditis and actively treat it.

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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.