What do you mean by Acute Pericarditis?
Ans.
Acute pericarditis is defined as acute inflammation of the pericardium and is clinically characterized by chest pain, fever, tachycardia and pericardial friction rub. It has characteristic electrocardiographic (ECG) changes. It is more common in men.
Etiology
a) Idiopathic: Most common cause, though many of these cases could be of viral etiology.
b) Viral: The Coxsackie B and Echovirus are most common pathogens.
c) Purulent: Purulent pericarditis due to staphylococci, pneumococci or strephtococci can occur.
d) Tuberculous: Tuberculosis can infect the pericardium resulting in tuberculous pericarditis.
e) Pericarditis in acute myocardial infarction: Transmural myocardial infarction can cause pericardial inflammation in 12 - 15 per cent of cases. It is more often detected in anterior wall myocardial infarction and inferior wall with right ventricular infarction. With the widespread use of reperfusion therapy, the incidence of pericarditis in acute myocardial infarction has significantly come down.
f) Uremic: Uremic patients can develop pericarditis.
g) Neoplastic: Malignant tumours especially of lung and breast and lymphomas can involve the pericardium leading to pericarditis with effusion.
h) Collagen Disorders: Collagen disorders like lupus erythematosis, rheumatic fever and rheumatoid disease can cause pericardial inflammation.
i) Dressler's Syndrome: Occurs 2 weeks to 2 years after acute myocardial infarction. The exact cause of Dressler's syndrome is not clear, though proposed to be autoimmune in nature.
j) Post pericardiotomy Syndrome: Occurs 6 to 8 weeks after cardiac surgery. Thought to be autoimmune in mechanism.
k) Rare infecting organisms: Rarely fungal, rickettsial, spirochetal and parasitic infections can lead to pericarditis.
l) Traumatic: Traumatic perforation of the pericardium during procedures like pacemaker insertion, catheter ablation for arrhythmias or interventional procedures or pericardial perforation from penetrating chest injury or oesophageal perforation can cause pericardial
inflammation.