Common Causes of Acute Pericarditis

Acute pericarditis is a syndrome caused by inflammation of the visceral and parietal layers of the pericardium. Understanding the underlying causes is essential for effective diagnosis and treatment. Below are the most common causes associated with this condition.

1. Idiopathic or Non-Specific Causes

In many cases, the exact cause of acute pericarditis remains unknown. These cases are often classified as idiopathic or non-specific. Despite the lack of a clear trigger, they account for a significant portion of diagnosed cases and are generally considered to have a favorable prognosis with appropriate care.

2. Infectious Agents

Infections are a major cause of acute pericarditis. Viral infections, such as those caused by coxsackievirus or echovirus, are among the most common. Bacterial infections, including purulent pericarditis, and tuberculosis-related pericarditis are also significant contributors, particularly in regions where tuberculosis is prevalent. Prompt identification and treatment of the infectious agent are crucial for improving outcomes.

3. Autoimmune and Inflammatory Conditions

Conditions such as rheumatoid arthritis and systemic lupus erythematosus can lead to pericardial inflammation. These immune-mediated forms of pericarditis often require a multidisciplinary approach to treatment, including immunosuppressive therapy in addition to standard anti-inflammatory medications.

4. Neoplastic and Traumatic Factors

Cancer, especially metastatic tumors that spread to the pericardium, is increasingly recognized as a cause of acute pericarditis. Additionally, trauma to the chest area, whether from injury or medical procedures like cardiac surgery, can also result in pericardial inflammation. In these cases, management often involves addressing the underlying malignancy or trauma.

Treatment and Prognosis

The treatment of acute pericarditis typically involves a combination of medications and, in some cases, surgical intervention. The primary goal is to reduce inflammation and alleviate symptoms. Commonly prescribed medications include nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and, in specific cases, antibiotics or antiviral agents depending on the cause.

Supportive Care

Rest is a critical component of recovery, and patients are often advised to avoid strenuous activities. Maintaining body warmth and monitoring for complications such as cardiac tamponade or constrictive pericarditis are also essential for ensuring a full recovery. With timely and appropriate treatment, most patients experience significant improvement within a few weeks.