What are the types of pericarditis?

Written by Tang Li

Cardiology

Updated on September 27, 2024

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Pericarditis includes primary infectious pericarditis, as well as non-infectious pericarditis caused by related diseases, such as tumors, metabolic diseases, autoimmune diseases, and uremia. Based on the progression of the condition, pericarditis can also be divided into acute pericarditis, with or without pericardial effusion, chronic pericarditis, adhesive pericarditis, subacute exudative constrictive pericarditis, and chronic constrictive pericarditis. Clinically, acute pericarditis and chronic constrictive pericarditis are the most common.

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Written by Tang Li

Cardiology

1min 34sec

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What are the clinical considerations for acute pericarditis?

The treatment and prognosis of acute pericarditis mainly depend on the cause, and are also related to whether it is diagnosed and treated correctly early on. For various types of pericarditis, if constrictive syndrome occurs, pericardiocentesis should be performed immediately to relieve symptoms. In cases like tuberculous pericarditis, if not treated aggressively, it can usually progress to chronic constrictive pericarditis. Acute nonspecific pericarditis and post-cardiac injury syndrome may lead to recurrent attacks of pericarditis after the initial episode, known as recurrent pericarditis, with an incidence rate of about 20%-30%. This is one of the most difficult complications of acute pericarditis to manage. Clinically, it generally presents similar to acute pericarditis, with recurrent attacks months or years after the initial episode, accompanied by severe chest pain. Most patients should be treated again with high doses of non-steroidal anti-inflammatory drugs, slowly tapering over several months until the medication can be stopped. If ineffective, corticosteroid treatment may be administered; in severe cases, intravenous methylprednisolone may be given, and symptoms in most patients may improve within a few days. However, it is important to note that symptoms often reappear during steroid tapering.

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Written by Xiong Hong Hai

Infectious Disease

42sec

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Is tuberculous pericarditis hereditary?

Tuberculous pericarditis is an infectious disease, not a hereditary disease. Most cases are due to tuberculosis of the lungs, after which the tuberculosis bacteria enter the bloodstream and cause tuberculous pericarditis in the pericardium. Tuberculous pericarditis is curable. If it is confirmed to be tuberculous pericarditis, it is necessary to start anti-tuberculosis treatment as soon as possible. It may also be necessary to combine some corticosteroids for treatment. With standardized anti-tuberculosis and symptomatic supportive treatment, it can generally be completely cured. Analysis should be tailored to the actual situation.

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Written by Tang Li

Cardiology

43sec

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What are the infectious causes of pericarditis?

The causes of pericarditis include the following types: first, acute nonspecific; second, tumors; third, autoimmune disorders; fourth, metabolic diseases; fifth, physical factors such as trauma and radiation; sixth, diseases of adjacent organs and tissues, such as acute myocardial infarction, pleurisy, aortic dissection, pulmonary embolism, etc. The infectious causes of acute pericarditis mainly include viruses, bacteria, fungi, parasites, and rickettsiae. Common types of pericarditis include tuberculous pericarditis and purulent pericarditis.

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Written by Xiong Hong Hai

Infectious Disease

40sec

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Tuberculous pericarditis differential diagnosis

The differential diagnosis of tuberculous pericarditis requires differentiation from other types of pericardial inflammation, such as bacterial pericarditis and nonspecific infections that lead to cellular inflammation of the pericardium. In addition to infections that can cause pericarditis, other infectious diseases such as subacute endocarditis and infections caused by other microbes can also lead to pericarditis. Furthermore, some rheumatic autoimmune diseases can also present with pericarditis. It is necessary to perform pericardiocentesis and fluid examination to determine the specific cause.

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Written by Liu Ying

Cardiology

1min 10sec

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How is constrictive pericarditis treated?

We say constrictive pericarditis refers to a disorder of circulatory disturbances caused by the heart being encased in a densely thickened fibrotic or calcified pericardium, which restricts the filling of the ventricles during diastole. Most patients with constrictive pericarditis will progress to chronic constrictive pericarditis. At this point, the only effective treatment method is pericardiectomy, but the perioperative risk is very high. A small portion of patients have short-term or reversible pericardial constriction, so for patients who are recently diagnosed and have stable conditions, it is possible to try anti-inflammatory treatment for 2-3 months unless complications such as cardiac cachexia, cardiogenic cirrhosis, or myocardial atrophy occur. For tuberculous pericarditis, anti-tuberculosis treatment is recommended to delay the progression of pericardial constriction, and post-surgery, anti-tuberculosis treatment should continue for one year.