Pericarditis

Definition

Pericarditis is a disorder caused by inflammation of the pericardium, which is the sac-like covering of the heart.

Causes, incidence, and risk factors

Pericarditis is usually a complication of viral infections, most commonly echovirus or cocksackie viruses. Less frequently, it can be caused by Influenza or HIV infection. Infections with bacteria can lead to bacterial pericarditis (also called purulent pericarditis). Some fungal infections can also produce pericarditis.

In addition, pericarditis can be associated with systemic diseases such as autoimmune disorders, Rheumatic fever, Tuberculosis, cancer, Leukemia, kidney failure, HIV infections, AIDS and Hypothyroidism.

Heart disorders that can cause pericarditis include Heart attack (see Post-MI pericarditis) and myocarditis. Radiation therapy to the chest and medications that suppress the immune system can also sometimes induce this condition.

Pericarditis can also result from injury (including surgery) or trauma to the chest, esophagus, or heart.

Quite often, the cause of pericarditis remains unknown, in which case it is called idiopathic pericarditis.

Pericarditis most often affects men aged 20-50, usually following respiratory infections. It can also occur in children, where it is most commonly caused by adenovirus or coxsackie virus.

Symptoms

• Chest pain , caused by the inflamed pericardium rubbing against the heart.
  o Usually relieved by sitting up and leaning forward
  o Pleuritis type: a sharp, stabbing pain
  o May radiate to the neck, shoulder, back or abdomen
  o Often increases with deep breathing and lying flat; may increase with coughing and swallowing
  
• Breathing difficulty when lying down (the patient prefers standing or sitting upright)
  
• Splinting of ribs (bending over or holding the chest) with breathing
  
• Dry cough
  
• Ankle, feet and leg swelling (occasionally)
  
• Anxiety