Pericarditis causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S [2] Ahmed Zaghw, M.D. [3] Homa Najafi, M.D.[4]


The causes of pericarditis can be divided into infectious and non-infectious ones. Infectious causes include bacterial, viral, fungal and, parasitic. While, non-infectious causes include autoimmune, neoplastic, metabolic, traumatic and iatrogenic, and drug-related. Acute myocardial infarction, Addisonian crisis, aortic dissection and rupture, blunt or penetrating chest trauma, esophageal perforation, gastric perforation, and myocardial rupture are life threatening causes of pericarditis. Common causes of pericarditis include viral, bacterial organisms, neoplasms, autoimmune and renal failure.


Life Threatening Causes

Life-threatening causes include conditions which may result in death or permanent disability within 24 hours if left untreated and include:[1][2][3][4]

Common Causes

Causes by Organ System

Cardiovascular Acute myocardial infarction, aortic rupture, benign obstruction of thoracic duct, dissecting aortic aneurysm, Dresslers syndrome, endocarditis, myocardial rupture, myocarditis
Chemical / poisoning Scombrotoxic fish poisoning
Dermatologic Behcet syndrome
Drug Side Effect Aminosalicylic acid, amiodarone, anticoagulants, bromocriptine, cromolyn sodium, certolizumab pegol, cyclosporine, cyclophosphamide, cytarabine, dantrolene, daunorubicin, doxorubicin, Doxycycline, 5-fluorouracil, hydantoin, hydralazine, isoniazid, mesalazine, methyldopa, methysergide, minoxidil, Olsalazine, penicillin, Pergolide, phenylbutazone, practolol, pramipexole, procainamide, procainamide, reserpine, ropinirole, streptokinase, streptomycin, sulfa drugs, Thalidomide, thiazides, thiouracil, thrombolytics, tocainide
Ear Nose Throat Temporal arteritis
Endocrine Addisonian crisis, hypothyroidism, myxedema
Environmental Asbestosis, polytetrafluoroethylene inhalation, silicosis
Gastroenterologic Inflammatory bowel disease, Whipple's disease
Genetic Gaucher disease, Jacobs arthropathy-camptodactyly syndrome, Mulibrey nanism syndrome, recurrent hereditary polyserositis
Hematologic Leukemia, lymphoma
Iatrogenic Cardiac catheterization, cardiopulmonary resuscitation, cathether ablation for arrhythmias, coronary artery bypass grafting, dialysis, heart surgery, pacemaker syndrome, percutaneous coronary intervention, postpericardiotomy syndrome, radiation therapy, TAVI, thoracic surgery, vaccines (smallpox, yellow fever), valvuloplasty
Infectious Disease Actinomycosis, adenovirus, alveolar hydatid disease, amebiasis, aspergillus, blastomycosis, borrelia, brucellosis, candida, chlamydia psittaci, coccidiomycosis, coxsackie B virus, cytomegalovirus, E.coli, EBV, echinococcus, ECHO virus, entamoeba histolytica, francisella, haemophilus influenza, hepatitis B, herpes viruses, histoplasmosis, HIV, infectious mononucleosis, influenza, klebsiella, legionella, Lyme disease, meningococci, mumps, mycobacterium tuberculosis, mycoplasma, neisseria, nocardia, pneumococcus, proteus, pseudomonas, rickettsia, salmonella, staphylococcus, streptococcus, toxoplasmosis, tularemia, ureaplasma, varicella
Musculoskeletal / Ortho Ankylosing spondylitis, dermatomyositis, polymyositis, Reiter's Syndrome, rheumatoid arthritis, Still's disease
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Angioma, breast cancer, carcinoid, fibroma, Kaposi's sarcoma, leiomyoma, leukemia, lipoma, lung cancer, lymphoma, melanoma, mesothelioma, neoplasia that has spread to the pericardium, ovarian cancer, rhabdomyosarcoma, sarcoma, Sipple syndrome, teratoma
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Lung cancer, pneumonia, sarcoidosis
Renal / Electrolyte Uremic pericarditis
Rheum / Immune / Allergy Acute rheumatic fever, amyloidosis, ankylosing spondylitis, Behcet syndrome, Dressler's syndrome, familial mediterranean fever, inflammatory bowel disease, Kawasaki disease, mixed connective tissue disease, polyarteritis nodosa, polymyositis, Reiter's Syndrome, rheumatoid arthritis, sarcoidosis, scleroderma, Still's disease, systemic lupus erythematosus, systemic sclerosis, temporal arteritis, Wegener's granulomatosis
Sexual Neisseria gonorrhoeae, treponema pallidum
Trauma Blunt or penetrating chest trauma, esophageal rupture, esophogeal perforation, gastric perforation, pancreatic-pericardial fistula
Urologic Renal failure, uremia
Miscellaneous Idiopathic

Causes in Alphabetical Order

Summery of causes

Pericarditis classification based on etiology
Infectious causes
Non-infectious causes

Enteroviruses(coxsackieviruses, echoviruses)

Herpes viruses(EBV, CMV, HHV-6)


Parvovirus B19

Mycobacterium tuberculosis

Coxiella burnetii

Borrelia burgdorferi

Histoplasma species

Aspergillus species

Blastomyces species

Candida species

Echinococcus species

Toxoplasma species

Systemic autoimmune and auto-inflammatory diseases

Systemic vasculitides


Familial Mediterranean fever


Still disease

Primary tumours (pericardial mesothelioma)

secondary metastatic tumors( lung and breast cancer, lymphoma)



Anorexia nervosa
Traumatic and Iatrogenic


Aortic dissection

Pulmonary arterial


Chronic heart failure

Congenital absence of the pericardium


  1. Imazio, Massimo (2012). "Contemporary management of pericardial diseases". Current Opinion in Cardiology. 27 (3): 308–317. doi:10.1097/HCO.0b013e3283524fbe. ISSN 0268-4705.
  2. Imazio, Massimo; Spodick, David H.; Brucato, Antonio; Trinchero, Rita; Adler, Yehuda (2010). "Controversial Issues in the Management of Pericardial Diseases". Circulation. 121 (7): 916–928. doi:10.1161/CIRCULATIONAHA.108.844753. ISSN 0009-7322.
  3. Imazio, Massimo; Brucato, Antonio; DeRosa, Francesco Giuseppe; Lestuzzi, Chiara; Bombana, Enrico; Scipione, Federica; Leuzzi, Stefano; Cecchi, Enrico; Trinchero, Rita; Adler, Yehuda (2009). "Aetiological diagnosis in acute and recurrent pericarditis: when and how". Journal of Cardiovascular Medicine. 10 (3): 217–230. doi:10.2459/JCM.0b013e328322f9b1. ISSN 1558-2027.
  4. Sliwa, Karen; Mocumbi, Ana Olga (2009). "Forgotten cardiovascular diseases in Africa". Clinical Research in Cardiology. 99 (2): 65–74. doi:10.1007/s00392-009-0094-1. ISSN 1861-0684.

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