PERICARDITIS

PERICARDITIS

DEFINATION:

PERICARDITIS….Inflammation of both the layers of pericardium…..

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Types:

. Acute (less than 6 weeks duration)

  1. Dry.
  2. With effusion.

Subacute (more than-6 weeks duration)

  1. Constrictive.
  2. With effusion.

Chronic (more than 6 months duration) 

  1. Constrictive
  2. Adherent mediastino-,,
  3. With effusion.

AETIOLOGY:

Infective

  1. Viral (Coxackle, echo, influenza, mumps, hepatitis, varicella, Epstein-Barr, HIV).
  2. Pyogenic (Strepto, Staphylococcal, Pneumococcal, sequela of infective endocarditis).
  3. Tubercular.
  4. Mycotic, fungal or parasitic infection.
  5. Spirochetal: Syphilis, Lyme disease.

Non-infective

  1. Myocardial infarction (within 24 hours of acute MI).
  2. Uraemia (Terminal pericarditis).
  3. Neoplasms (Primary and secondary), lung and oesophagal cancer, Hodgkin’s lymphoma, breast cancer and renal cell cancer are common to involve the heart from adjacent sites. Primary tumour of the pericardium, e.g. mesoendothelioma or sarcoma may also occur.
  4. Myxodema.
  5. Trauma (penetrating and non-penetrating).
  6. During anti-coagulant therapy.
  7. Chylopericardium (in filariasis)
  8. Dissecting aneurysm with haemopericardium.
  9. Severe anemia.
  10. Radiation (it is a subacute or chronic pericarditis developing within one year but may be delayed)
  11. Serum sickness.
  12. Idiopathic (Acute benign pericarditi).

Autoimmunity or Hyperensitivity reaction :

  1. Rheumatic fever.
  2. Collagenosis.
  3. Iatrogenic or drug induced. Procainamide, Isoniazid, Hydralazine, Minoxidil, Penicillin, Methysezide.
  4. Post-cardiac injury (one week to several months after cardiac injury).
  5. a) Dressler’s syndrome.
  6. B) Post pericardiotomy syndrome.