Pericarditis: Understanding the Causes and Risk Factors

Pericarditis, an inflammation of the pericardium — the thin, double-layered sac that surrounds the heart — can occur due to a variety of underlying conditions. In most cases, pericardial disease develops as a secondary complication of another illness. In some instances, it may present as the primary symptom, allowing for identification of a specific cause. However, in a minority of cases, the exact cause remains elusive despite thorough clinical and pathological evaluation.

Common Causes of Pericarditis

Medical experts have identified several key factors that contribute to the development of pericarditis. These can be broadly categorized into infectious and non-infectious causes, each with distinct subtypes and implications for treatment and management.

1. Idiopathic or Non-Specific Pericarditis

This type of pericarditis is diagnosed when clear clinical or pathological signs of inflammation are present, but no identifiable cause can be determined. Often referred to as idiopathic pericarditis, it accounts for a significant portion of cases and may be linked to mild viral infections that resolve on their own before diagnosis.

2. Infectious Causes of Pericarditis

Infections are among the most common triggers of pericarditis. These can be bacterial, viral, fungal, or parasitic in nature:

• Bacterial infections: Include common pathogens such as Streptococcus, Staphylococcus, and pneumococcal species, as well as Mycobacterium tuberculosis, which can lead to tuberculous pericarditis.
• Viral infections: Coxsackieviruses, echoviruses, influenza viruses, and adenoviruses are frequently implicated in viral pericarditis.
• Fungal infections: Less common but serious causes include Histoplasma, Coccidioides, Candida, and Actinomyces species.
• Parasitic and other infections: Rare causes include parasites such as Entamoeba histolytica, Toxoplasma gondii, and Echinococcus, as well as Chlamydia and other atypical pathogens.

3. Non-Infectious Causes of Pericarditis

Non-infectious pericarditis is also relatively common and can arise from a wide range of conditions, including:

• Cardiovascular diseases: Such as myocardial infarction (heart attack), cardiac surgery, or trauma to the chest area.
• Malignancies: Both primary and metastatic tumors can involve the pericardium, especially those originating from the lung, breast, or lymphatic system.
• Uremia: A buildup of toxins in the blood due to kidney failure, which can cause pericardial inflammation.
• Autoimmune disorders: Including systemic lupus erythematosus (SLE), rheumatoid arthritis, and scleroderma.
• Metabolic and endocrine conditions: Such as hypothyroidism or severe lipid disorders.
• Physical trauma: From radiation therapy, chest injuries, or invasive heart procedures.
• Medication-induced: Certain drugs, including some chemotherapy agents and anticoagulants, have been associated with pericardial inflammation.

Understanding the underlying cause of pericarditis is crucial for effective treatment. While some cases may resolve on their own, others require targeted therapy based on the specific etiology. If you experience symptoms such as chest pain, shortness of breath, or palpitations, it is important to consult a healthcare provider for proper diagnosis and management.