From the Research
The top 5 common causes of pericarditis are idiopathic (presumed viral), viral infections, post-cardiac injury syndromes, bacterial infections, and autoimmune disorders, with incidence rates varying significantly based on geographic location and patient population. According to the most recent and highest quality study 1, pericarditis typically presents with classic symptoms of acute sharp, retrosternal, and pleuritic chest pain, and can have several different underlying causes including viral, bacterial, and autoimmune etiologies. The main causes of pericarditis include:
- Idiopathic (presumed viral), which accounts for approximately 80-90% of cases in developed countries
- Viral infections (specifically identified), representing about 10-20% of cases
- Post-cardiac injury syndromes (including post-myocardial infarction and post-pericardiotomy), occurring in 5-15% of patients after cardiac surgery or myocardial infarction
- Bacterial infections, which are relatively rare at less than 5% of cases in developed countries but more common in developing regions
- Autoimmune disorders (such as systemic lupus erythematosus, rheumatoid arthritis, and systemic sclerosis), which collectively account for approximately 5-10% of cases. In clinical practice, identifying the specific etiology is important as it guides treatment approaches, with most cases responding to anti-inflammatory therapy using NSAIDs like ibuprofen (600-800mg three times daily) or aspirin (750-1000mg three times daily) combined with colchicine (0.5mg twice daily for patients >70kg or once daily for those <70kg) for 3 months to prevent recurrence, as supported by previous studies 2, 3. It's worth noting that the addition of colchicine to prednisone in patients admitted for acute idiopathic pericarditis does not reduce the risk of recurrence, as found in a study 4, highlighting the importance of considering the specific treatment approach based on the underlying cause of pericarditis.