In pericarditis (synonyms: Acute bacterial pericarditis with seropurulent effusion; Acute bacterial pericarditis with serous effusion; Acute benign pericarditis; Acute myopericarditis; Acute nonrheumatic pericarditis; Acute pericarditis; Acute pericardial effusion; Acute nonspecific idiopathic pericarditis; Purulent fibrinous pericarditis; Purulent pericarditis; Fibrinous pericarditis; Idiopathic pericarditis; Infectious pericarditis; Pericarditis purulenta; Pericardial abscess; Pneumococcal pericarditis; Staphylococcal pericarditis; Streptococcal pericarditis; Pneumopyopericardium; Pyopericardium; Pyopericarditis; Pyopneumopericardium; Septic pericarditis; Serofibrinous pericarditis; Suppurative pericarditis; Viral pericarditis; ICD-10 I30. -: Acute pericarditis) is the inflammation of the connective tissue pericardium (pericardium; Latin pericardium, Latinized form of the ancient Greek περί “around” and καρδιά “heart“). Differentiation from myocarditis (inflammation of the heart muscle) is not always possible. Almost always, this is also affected by the inflammation (perimyocarditis). Acute pericarditis is the most common disease of the pericardium. Persistent pericarditis is when symptoms persist for more than 4 to 6 weeks, but no longer than 3 months. Chronic pericarditis is when symptoms persist for > 3 months. Recurrent pericarditis is when pericarditis recurs after a 4-6 week symptom-free interval. Recurrent pericarditis is when a documented initial period of acute pericarditis is followed by a symptom-free interval of 4-6 weeks or longer (usually within 18-24 months). The acute form can be distinguished from the chronic form:
- Acute form
- Acute fibrinous pericarditis – associated with the formation of fibrin.
- Acute exudative pericarditis – associated with exudation of blood components.
- Subacute form:
- Subacute exudative-constrictive pericarditis – associated with exudation of blood components and congestion.
- Subacute constrictive pericarditis – subacute, associated with exertional dyspnea (shortness of breath on exertion), signs of right-sided heart failure (right-sided heart failure) and typical hemodynamics
- Chroic form:
According to the cause, pericarditis can be divided into:
- Infectious pericarditis – in about 80% of cases, viruses are the triggers; rarely, bacteria, mycoses or parasites are responsible.
- Non-infectious pericarditis
Idiopathic pericarditis (with no apparent cause) is present in 5-50% of cases. Peak incidence: males aged 16-65 years have a higher risk of developing pericarditis (relative risk 2.02) than females
The clinically recorded incidence (frequency of new cases) for acute pericarditis is approximately 1 case per 1,000 population per year (in Germany). The number is probably higher, since many pericarditis cases remain undetected. Course and prognosis: It is not uncommon to find concomitant diseases such as pericardial effusion (accumulation of fluid in the pericardium) or fibrosis (pathological (abnormal) proliferation of connective tissue) as well as calcifications. As a result, cardiac function is significantly impaired. The course of the disease depends on the cause. In most cases, pericarditis shows a benign (good) course. The common viral pericarditis heals after about 1-3 weeks. If complications occur, this takes an unfavorable course on the disease. Consequently, those affected must be well monitored. Pericarditis can become chronic. In such cases, the affected individuals are no longer able to exercise sufficiently.The long-term prognosis of most patients with acute pericarditis (especially those with viral or idiopathic pericarditis) is good. Pericarditis occurs recurrently (recurring). The recurrence rate is 15-30%. Serious complications of idiopathic recurrent pericarditis are uncommon.The lethality (mortality relative to the total number of people with the disease) in the setting of bacterial pericarditis is as high as 50%.
