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PostPosted: Wed Mar 28, 2007 6:26 pm 
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Etiology of pericardial disease
Ralph Shabetai, MD
G Ralph Corey, MD

UpToDate performs a continuous review of over 375 journals and other resources. Updates are added as important new information is published. The literature review for version 15.1 is current through December 2006; this topic was last changed on December 28, 2006. The next version of UpToDate (15.2) will be released in June 2007.


The pericardium may be involved in a large number of systemic disorders or may be diseased as an isolated process. The principal manifestations of pericardial disease are pericarditis and pericardial effusion. While these are distinct phenomena, most patients with pericardial disease present with both manifestations to a greater or lesser degree. In some cases, the clinical presentation of acute pericardial inflammation predominates, and the presence of excess pericardial fluid is clinically unimportant. In other cases, the effusion and its clinical consequences are of primary importance. (See "Evaluation and management of acute pericarditis" and see "Diagnosis and treatment of pericardial effusion"

This topic will provide a brief overview of the major causes of pericardial disease. Many of the specific disorders are discussed separately in the appropriate topic reviews.


The etiology of pericardial diseases is best considered by using a modification of the time-honored pathologic classification of disease into inflammatory, neoplastic, degenerative, vascular, and idiopathic (show table 1) [1-3]. The major causes include:

Viral infection, including HIV
Purulent pericarditis
Mediastinal radiation, recent or remote
Myocardial infarction
Cardiac surgery
Recent or remote sharp or blunt chest trauma
Cardiac diagnostic or interventional procedure
Drugs and toxins
Metabolic disorders, especially uremia, dialysis, and hypothyroidism
Malignancy, especially lung and breast cancer, Hodgkin's disease, mesothelioma
Collagen vascular diseases
Pericardial disease may also be a feature of other disorders, including inflammatory bowel disease and meningitis. The mechanism for these associations is not known.

Most of the etiologies of pericardial disease listed above can cause both "dry" pericarditis (that is, pericarditis with minimal or no effusion) and pericardial effusive disease. Some causes are primarily associated with effusion without significant pericardial inflammation, such as HIV infection and hypothyroidism.


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PostPosted: Fri Jun 12, 2015 1:47 pm 

Joined: Tue Mar 03, 2015 11:57 am
Posts: 775
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