"Shot through the heart, and you're to blame.....You give love a bad name "......Bon Jovi, circa 1986

Pericarditis: an approach....

1. Idiopathic: many patients do not have an underlying etiology established. We assume that many of these patients have a 'viral' pericarditis.
2. Infectious:
   • Viral: classically Coxsackie, Echovirus, and Adenovirus, but certainly others.
   • Bacterial: think about Staph and Strep species, and never forget TB (mycobacterial)
   • Fungal: Histoplasmosis, Aspergillosis, Blastomycosis
   • Parasitic: Toxoplasomosis, Echinococcus
3. Malignant: usually metastatic disease like lung or breast cancers, or lymphoma.
4. Autoimmune: Think about lupus, rheumatoid arthritis, and mixed connective tissue diseases.
5. Metabolic: Uremic pericarditis is common, and hypothyroidism can cause a pericardial effusion.
6. Cardiac: a pericarditis can be seen early after an infarction, or sometimes within 3-4 weeks afterwards....the so called Dressler's Syndrome.
7. Drugs: can cause a drug-induced lupus. Common culprits include procainamide, INH, and hydralazine.
8. Other things: Radiation, Trauma.