Acute Pericarditis Types and Classifications

Acute pericarditis can be classified into different types based on its duration and underlying causes. Understanding these classifications helps in diagnosing and managing the condition more effectively.

Classification by Duration

1. Acute Pericarditis (Duration < 6 Weeks)

This type of pericarditis lasts less than six weeks and includes both fibrinous and exudative forms. It often presents with sudden onset symptoms such as chest pain and may be associated with mild to moderate pericardial effusion.

2. Subacute Pericarditis (Duration 6 Weeks to 3 Months)

When symptoms persist between six weeks and three months, it is categorized as subacute pericarditis. This form may involve either exudative changes or progress to constrictive pericarditis, where the heart's movement becomes restricted due to scarring or thickening of the pericardium.

Classification by Cause

1. Infectious Pericarditis

Infectious causes include viral, bacterial, tuberculous, and fungal pericarditis. Among these, viral pericarditis is the most common type. Patients often experience chest pain approximately 10–12 days before other viral symptoms appear. Some may also show signs of pneumonia or pleuritis, along with small amounts of pericardial fluid.

2. Non-Infectious Pericarditis

This category includes pericarditis resulting from various non-infectious conditions such as myocardial infarction, uremia, malignancies, adenomas, cholesterol-related effusions, chylous pericardial fluid, trauma, drug-induced cases, and post-surgical or post-traumatic complications. These types can be challenging to diagnose and require a thorough evaluation of the patient's medical history and current condition.

3. Idiopathic Acute Pericarditis

When no specific cause can be identified despite comprehensive testing, the condition is referred to as idiopathic acute pericarditis. It accounts for a significant portion of diagnosed cases and typically responds well to conservative treatment.

Common Types of Pericarditis

Tuberculous pericarditis is another frequently encountered type, especially in regions where tuberculosis is endemic. It may present with minimal symptoms such as low-grade fever or mild chest discomfort, but often involves significant pericardial effusion. Unlike viral pericarditis, it may not present with acute chest pain and can be more insidious in onset.

Recognizing the different types of acute pericarditis is essential for effective treatment planning and long-term management. Early diagnosis and appropriate therapy can significantly improve patient outcomes and reduce the risk of complications such as cardiac tamponade or chronic constrictive pericarditis.