Pericarditis: Or something else? Differential Diagnosis

Blood, blood-forming organs-immune system (D50-D90).

  • Sarcoidosis – inflammatory systemic disease affecting primarily the skin, lungs, and lymph nodes.

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Amyloidosis – extracellular (“outside the cell”) deposits of amyloids (degradation-resistant proteins) that can lead to cardiomyopathy (heart muscle disease), neuropathy (peripheral nervous system disease), and hepatomegaly (liver enlargement), among other conditions.
  • Familial Mediterranean fever (FMF; synonym: familial recurrent polyserositis) – autosomal recessive inherited disease clustered in residents of the eastern Mediterranean region; chronic disease characterized by sporadic episodes of fever with concomitant inflammation of the tunica serosa, resulting in abdominal pain (abdominal pain), thoracic pain, or arthralgia (joint pain).
  • Myxedema – common symptom of hypothyroidism (underactive thyroid); pasty (puffy; bloated) skin showing non-push-in, doughy edema (swelling) that is not positional; facial and peripheral; occurring primarily on the lower legs

Cardiovascular system (I00-I99).

  • Acute myocardial infarction (heart attack).
  • Aortic dissection (synonym: aneurysm dissecans aortae) – acute splitting (dissection) of the wall layers of the aorta (main artery), with a tear of the inner layer of the vessel wall (intima) and hemorrhage between the intima and the muscular layer of the vessel wall (outer media), in the sense of an aneurysm dissecans (pathological expansion of the artery).
  • Dressler syndrome (synonyms: postmyocardial infarction syndrome, postcardiotomy syndrome) – pericarditis (inflammation of the pericardium) and/or pleurisy (inflammation of the pleura) occurring several weeks (1-6 weeks) after a myocardial infarction (heart attack) or injury to the myocardium (heart muscle) as a late immunological reaction at the pericardium (pericardium) after the formation of heart muscle antibodies (HMA).
  • Chylopericardium – lymphatic effusion in the pericardium.
  • Familial pericarditis
  • Heart failure (cardiac insufficiency), chronic
  • Pulmonary hypertension – pressure increase in the pulmonary artery system.
  • Rheumatic fever – specific reaction that occurs after infection with serogroup A streptococci, leading to arthritides (inflammation of joints), inflammation of the heart such as peri/myocarditis (pericarditis/heart muscle inflammation), and CNS involvement in the form of chorea minor (neurologic autoimmune disease characterized by hyperkinesia – uncontrollable lightning-like outward movements – muscle hypotonia and hyporeflexia)

Infectious and parasitic diseases (A00-B99).

Mouth, esophagus (esophagus), stomach, and intestines (K00-K67; K90-K93).

  • Ulcerative colitischronic inflammatory bowel disease (colon and rectum).
  • Crohn’s disease – chronic inflammatory bowel disease; it usually progresses in relapses and can affect the entire digestive tract; characteristic is the segmental affection of the intestinal mucosa (intestinal mucosa), that is, several intestinal sections may be affected, which are separated from each other by healthy sections
  • Whipple’s disease – rare systemic infectious disease; caused by the gram-positive rod bacterium Tropheryma whippelii (from the group of actinomycetes), which can affect various other organ systems in addition to the obligately affected intestinal system and is a chronic recurrent disease; symptoms: Fever, arthralgia (joint pain), brain dysfunction, weight loss, diarrhea (diarrhea), abdominal pain (abdominal pain), and more.

Musculoskeletal system and connective tissue (M00-M99).

  • Gout (arthritis urica/uric acid-related joint inflammation or tophic gout)/hyperuricemia (elevation of uric acid levels in the blood).
  • Collagenoses (group of connective tissue diseases caused by autoimmune processes) – systemic lupus erythematosus (SLE), polymyositis (PM) or dermatomyositis (DM), Sjögren’s syndrome (Sj), scleroderma (SSc), and Sharp syndrome (“mixed connective tissue disease”, MCTD).
  • Bekhterev’s disease (ankylosing spondylitis) – chronic inflammatory rheumatic disease that affects only the spine and its boundary joints.
  • Reactive arthritis (synonym: postinfectious arthritis / joint inflammation) – secondary disease after gastrointestinal (gastrointestinal tract concerning), urogenital (urinary and genital organs concerning) or pulmonary (lungs concerning) infections; denotes an arthritis, where pathogens in the joint (usually) can not be found (sterile synovialitis).
  • Reiter’s disease (synonyms: Reiter’s syndrome; Reiter’s disease; arthritis dysenterica; polyarthritis enterica; postenteritic arthritis; posturethritic arthritis; undifferentiated oligoarthritis; urethro-oculo-synovial syndrome; Fiessinger-Leroy syndrome; English Sexually acquired reactive arthritis (SARA)) – special form of a “reactive arthritis” (see above. ); secondary disease after gastrointestinal or urogenital infections, characterized by the symptoms of Reiter’s triad; seronegative spondyloarthropathy, which is triggered especially in HLA-B27 positive persons by an intestinal or urinary tract disease with bacteria (mostly chlamydia); Can manifest as arthritis (joint inflammation), conjunctivitis (conjunctivitis), urethritis (urethritis) and partly with typical skin changes.
  • Rheumatoid arthritis – chronic inflammatory multisystem disease, which usually manifests itself in the form of synovitis (synovial inflammation).
  • Vasculitides (immunoreactively triggered inflammation of blood vessels; e.g., eosinophilic granulomatosis with polyangiitis (EGPA), formerly Churg-Strauss syndrome (CSS) or granulomatosis with polyangiitis (GPA), formerly Wegener’s granulomatosis).

Neoplasms – tumor diseases (C00-D48).

  • Malignant neoplasms, unspecified, with pericardial involvement (eg, bronchial carcinoma/lung cancer, breast carcinoma/breast cancer, leukemias, lymphomas, melanomas, non-Hodgkin’s lymphomas, sarcoma) – pericarditis may be an early sign of malignancy: within a median follow-up period of 6.4 years, the risk of cancer was increased by 50% (HR 1.5; 95% CI 1.4-1.5)

Psyche-Nervous System (F00-F99; G00-G99).

  • Anorexia nervosa (anorexia nervosa)

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

  • Renal insufficiency (kidney weakness) with signs of uremia (occurrence of urinary substances in the blood above normal levels).

Injuries, poisoning, and other consequences of external causes (S00-T98).

  • Injuries to the chest, unspecified

Other causes

Medication

  • See “Causes” under medications