Constrictive pericarditis causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Huda A. Karman, M.D.
Overview
Constrictive pericarditis is most commonly caused by conditions or events that cause inflammation to develop around the heart, including idiopathic, infectious (viral, bacterial, tuberculous, fungal, parasitic ) and purulent pericarditis. It can also occur post MI (Dressler syndrome), post surgical (CABG), post radiation therapy. Constrictive pericarditis can also be caused by or associated with connective tissue disease, pulmonary asbestosis, chronic renal failure, neoplasm (mesothelioma).
Causes
Common Causes
Constrictive pericarditis is most commonly caused by conditions or events that cause inflammation to develop around the heart, including:
- Coronary artery bypass graft surgery: In patients who have undergone coronary artery bypass surgery with pericardial sparing, there is danger of tearing a bypass graft while removing the pericardium. If any pericardium is not removed, it is possible for bands of pericardium to cause localized constriction which may cause symptoms and signs consistent with constriction.
- Radiation therapy to the chest [1]
- Tuberculosis. This is the most frequent cause of constriction in Africa and Asia.
- Post viral pericarditis
- Post-surgical
- Prior mediastinal radiation therapy
- Chronic renal failure (uremic pericarditis) [2]
- Connective tissue disorders
- Neoplastic pericardial infiltration
- Incomplete drainage of purulent pericarditis
- Fungal and parasitic infections
- Following pericarditis associated with ST elevation myocardial infarction (Dressler’s syndrome)
- In association with pulmonary asbestosis
- Mesothelioma
- Bacterial, viral, or surgical infections that cause abnormal buildup in the covering of the heart
Causes by Organ System
| Cardiovascular | Chylopericardium, Rheumatic pericarditis, Coronary artery bypass graft surgery, Post mediastinal surgery, Post viral pericarditis, Neoplastic pericardial infiltration, Dressler’s syndrome |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Bromocriptine, Hydralazine, Methysergide, Procainamide |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | No underlying causes |
| Genetic | Mulibrey nanism |
| Hematologic | No underlying causes |
| Iatrogenic | Coronary artery bypass graft surgery, Implantation of an automated implantable cardiac defibrillator, Implantation of an epicardial pacemaker, Incomplete drainage of purulent pericarditis, Orthopedic heart transplant, Post mediastinal surgery, Prior mediastinal radiation therapy, Radiation therapy, Sclerotherapy for esophageal varices. |
| Infectious Disease | Adenovirus, Bacterial infections, Coxsackievirus, Echovirus, Fungal infections, Hepatitis viruses, Pneumococcal pneumonia, Post viral pericarditis, Tuberculosis |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | No underlying causes |
| Nutritional / Metabolic | No underlying causes |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | Mesothelioma, Neoplastic pericardial infiltration |
| Opthalmologic | No underlying causes |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | In association with pulmonary asbestosis, Pneumococcal pneumonia, Mesothelioma |
| Renal / Electrolyte | Chronic renal failure, Uremia |
| Rheum / Immune / Allergy | Connective tissue disorders, Dressler’s syndrome, Rheumatoid arthritis, Sarcoidosis, Systemic sclerosis |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Dental | No underlying causes |
| Miscellaneous | No underlying causes |
Causes in Alphabetical Order
- Adenovirus
- Bacterial infections
- Chronic renal failure
- Chylopericardium
- Connective tissue disorders
- Coronary artery bypass graft surgery
- Coxsackievirus
- Dressler’s syndrome
- Echovirus
- Fungal infections
- Hepatitis viruses
- Hydralazine
- Implantation of an automated implantable cardiac defibrillator
- Implantation of an epicardial pacemaker
- In association with pulmonary asbestosis
- Incomplete drainage of purulent pericarditis
- Mesothelioma
- Methysergide
- Mulibrey nanism
- Neoplastic pericardial infiltration
- Orthopedic heart transplant
- Pneumococcal pneumonia
- Post mediastinal surgery
- Post viral pericarditis
- Prior mediastinal radiation therapy
- Procainamide
- Radiation therapy
- Rheumatic pericarditis
- Rheumatoid arthritis
- Sarcoidosis
- Sclerotherapy for esophageal varices.
- Systemic sclerosis
- Tuberculosis
- Uremia
References
- ↑ Armanious MA, Mohammadi H, Khodor S, Oliver DE, Johnstone PA, Fradley MG (2018). “Cardiovascular effects of radiation therapy”. Curr Probl Cancer. 42 (4): 433–442. doi:10.1016/j.currproblcancer.2018.05.008. PMID 30006103.
- ↑ Rehman KA, Betancor J, Xu B, Kumar A, Rivas CG, Sato K; et al. (2017). “Uremic pericarditis, pericardial effusion, and constrictive pericarditis in end-stage renal disease: Insights and pathophysiology”. Clin Cardiol. 40 (10): 839–846. doi:10.1002/clc.22770. PMC 6490618. PMID 28873222.
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