Pericarditis is the inflammation of the pericardial sac with or without pericardial effusion
Accounts for approximately 5% of visits to the emergency room for chest pain without myocardial infarction (MI)
Pericardial syndromes include diseases of the pericardium with characteristic manifestations that can be formed into “syndromes”
Include pericarditis, pericardial effusion, cardiac tamponade, constrictive pericarditis and effusive-constrictive pericarditis
Etiology
Cause in ≥80% of cases is either postviral or idiopathic in developed countries while tuberculosis (TB) is the most common cause in developing countries where it is endemic
Viral causes include echovirus, coxsackievirus, cytomegalovirus (CMV), herpes virus, adenovirus, influenza, human immunodeficiency virus (HIV), hepatitis C virus (HCV), parvovirus B19, SARS-CoV-2
A non-infectious cause accounts for 15-20% of acute pericarditis cases and include autoimmune and metabolic disorders, neoplastic pericarditis or may be drug related (eg antineoplastics, vaccines [including COVID-19 vaccines], lupus-like syndrome-inducing drugs)
Signs and Symptoms
Chest pain is central, sharp, pleuritic, worse with inspiration or lying down and improves with sitting up and leaning forward; pain may also radiate to the trapezius ridge
Risk Factors
In the general admitted population, at higher risk for pericarditis are men 16-65 years of age than women
