Inflammation of the pericardium

Aetiology

Infection

• Viral - mainly echoviruses, viruses produce serous effusions
• Bacterial - enter pericardium from infection somewhere else via bloodstream e.g. pneumonia, produce purulent effusions
• Fungi - immunosuppressed patients, produce purulent effusions
• TB - caseous material in pericardial sac

Post MI - Dressler’s syndrome

• 4-6 weeks post MI
• Assumed to be immune mediated - damaged heart muscle releases previously unencountered material that stimulates an immune response

Other causes

• Immune mediated - rheumatic fever
• Idiopathic
• Uraemic (renal failure)
• Connective tissue disorder e.g. SLE

Clinical features

Symptoms

• Pleuritic chest pain
  • Worse on inspiration
  • Relieved by sitting up

Signs

• Low grade fever