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 Liu Ying

Cardiology

1min 1sec

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Symptoms of acute pericarditis

Acute pericarditis is an acute inflammatory disease of the visceral and parietal layers of the pericardium, with the most common cause being viral infections. The hallmark of acute pericarditis is pain in the precardiac area behind the sternum. The nature of the pain is very sharp, typically occurring during the fibrinous exudation phase of inflammatory changes, caused by friction between the visceral and parietal layers of the pericardium. The pain can radiate to the neck, left shoulder, and even the upper abdomen. It is associated with respiratory movements and often worsens with coughing, deep breathing, or changing body positions. When fluid exudes into the pericardium, separating the visceral and parietal layers, the patient's pain may decrease or disappear. However, some patients may experience symptoms such as breathing difficulties and edema due to cardiac tamponade.

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Written by Liu Ying

Cardiology

1min

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Constrictive pericarditis clinical manifestations

Patients with constrictive pericarditis often have a history of pericarditis, pericardial effusion, malignant tumors, and other diseases. Some patients have an insidious onset with no obvious clinical symptoms in the early stages. The main symptoms can include palpitations, exertional dyspnea, decreased exercise tolerance, fatigue, enlarged liver, pleural effusion, abdominal effusion, and edema of the lower limbs. Patients with constrictive pericarditis commonly present with elevated jugular venous pressure, and often have a reduced pulse pressure. Most patients exhibit a negative apical beat during systole, with a commonly faster heart rate. The rhythm can be sinus, atrial, or ventricular, with premature contractions possible, as well as Kussmaul's sign. In the late stages, muscle atrophy, cachexia, and severe edema can occur.

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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 Han Shun Li

Pulmonology

44sec

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What causes constrictive pericarditis?

Constrictive pericarditis refers to the fibrosis or calcification of the pericardium, which restricts the filling of the ventricles during diastole and leads to a series of symptoms. What causes constrictive pericarditis? Generally, constrictive pericarditis is secondary to acute pericarditis. In our country, the most common cause of constrictive pericarditis is tuberculous pericarditis, followed by purulent or traumatic pericarditis. A minority of constrictive pericarditis cases may be associated with tumors of the pericardium, acute nonspecific pericarditis, and radiation-induced pericarditis, among others. Of course, some patients have idiopathic constrictive pericarditis.

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Written by Tang Li

Cardiology

1min 42sec

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What are the symptoms of pericarditis?

Fibrinous pericarditis is primarily characterized by precordial pain, similar to that seen in acute nonspecific pericarditis and infectious pericarditis. Tuberculous or neoplastic pericarditis that develops slowly may not show obvious pain symptoms. The nature of the pain can be sharp and related to respiratory movements. It is often exacerbated by coughing, deep breathing, changing body position, or swallowing. The pain is located in the precordial area and may radiate to the neck, left shoulder, left arm, and left scapula, and can also reach the upper abdomen. The pain can be compressive and located behind the sternum. The most prominent symptom of exudative pericarditis is dyspnea, which may be associated with bronchopulmonary compression and pulmonary congestion. In severe cases of dyspnea, the patient may sit up to breathe, leaning forward, with rapid and shallow breathing and pale complexion. There may be hepatomegaly, as well as compression of the trachea and esophagus causing dry cough, hoarseness, and difficulty swallowing. Rapid pericardial effusion can lead to acute cardiac tamponade, presenting with significant tachycardia and decreased blood pressure. Reduced pulse pressure and increased venous pressure, if the cardiac output significantly drops, can lead to shock. If the fluid accumulates slowly, it could lead to subacute or chronic cardiac tamponade, characterized by systemic venous congestion and distended jugular veins.