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Harvard Medical School

Pericarditis

What Is It?

Pericarditis is an inflammation of the pericardium, the saclike membrane around the heart. Pericarditis can be triggered by many, very different medical conditions, including:

• Viral infection — Viral pericarditis can be caused by an infection by several types of viruses, including coxsackieviruses, echoviruses, adenoviruses, the human immunodeficiency virus (HIV) and the viruses that cause mumps or hepatitis.

• A pyogenic (pus-producing) infection — Pyogenic pericarditis is an infection surrounding the heart that produces pus. It has several causes, including rupture (breaking open) of the esophagus (food tube), an infection after cardiothoracic surgery, or the spread of endocarditis, an infection of the heart lining and heart valves.

• Tuberculosis — Tuberculous pericarditis can occur as part of an active tuberculosis infection.

• Uremia — Uremic pericarditis can occur in people with uremia, an accumulation of urea and other waste products in the blood caused by kidney failure.

• Heart attack (myocardial infarction) — Pericarditis can be triggered by the destruction of heart muscle in a heart attack.

• Cardiac injury — As in heart attack, heart damage caused by trauma (a stab wound or severe blow to the chest) or cardiac surgery also can trigger pericarditis.

• Rheumatic or collagen vascular disease — Rheumatic diseases (rheumatoid arthritis, scleroderma and polyarteritis nodosa) and collagen vascular diseases, especially systemic lupus erythematosus (SLE or lupus), also can cause pericarditis.

Other rare causes of pericarditis include radiation therapy to treat cancers in the chest, cancer in the chest area, syphilis, a fungal infection or a parasitic infection. Sometimes, no definite cause can be found.

In some people with pericarditis, a fluid (effusion) accumulates within the saclike pericardium, a condition called pericardial effusion. If the pericardial effusion is large enough, it can interfere with the heart's ability to fill normally and to pump blood, a condition called cardiac tamponade. In other people, the earlier stage of pericarditis progresses to constrictive pericarditis, a condition in which the inflamed pericardium thickens and contracts around the heart, interfering with heart function.

Pericarditis is an inflammation of the pericardium, the saclike membrane around the heart. Pericarditis can be triggered by many, very different medical conditions, including:

• Viral infection — Viral pericarditis can be caused by an infection by several types of viruses, including coxsackieviruses, echoviruses, adenoviruses, the human immunodeficiency virus (HIV) and the viruses that cause mumps or hepatitis.

• A pyogenic (pus-producing) infection — Pyogenic pericarditis is an infection surrounding the heart that produces pus. It has several causes, including rupture (breaking open) of the esophagus (food tube), an infection after cardiothoracic surgery, or the spread of endocarditis, an infection of the heart lining and heart valves.

• Tuberculosis — Tuberculous pericarditis can occur as part of an active tuberculosis infection.

• Uremia — Uremic pericarditis can occur in people with uremia, an accumulation of urea and other waste products in the blood caused by kidney failure.

• Heart attack (myocardial infarction) — Pericarditis can be triggered by the destruction of heart muscle in a heart attack.

• Cardiac injury — As in heart attack, heart damage caused by trauma (a stab wound or severe blow to the chest) or cardiac surgery also can trigger pericarditis.

• Rheumatic or collagen vascular disease — Rheumatic diseases (rheumatoid arthritis, scleroderma and polyarteritis nodosa) and collagen vascular diseases, especially systemic lupus erythematosus (SLE or lupus), also can cause pericarditis.

Other rare causes of pericarditis include radiation therapy to treat cancers in the chest, cancer in the chest area, syphilis, a fungal infection or a parasitic infection. Sometimes, no definite cause can be found.

In some people with pericarditis, a fluid (effusion) accumulates within the saclike pericardium, a condition called pericardial effusion. If the pericardial effusion is large enough, it can interfere with the heart's ability to fill normally and to pump blood, a condition called cardiac tamponade. In other people, the earlier stage of pericarditis progresses to constrictive pericarditis, a condition in which the inflamed pericardium thickens and contracts around the heart, interfering with heart function.