What are the most common causes of pericarditis (inflammation of the pericardium)?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: March 6, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

The most common causes of pericarditis include viral infections, autoimmune disorders, and idiopathic factors, with viral pericarditis being the most prevalent, typically caused by coxsackieviruses, echoviruses, adenoviruses, and influenza viruses, as reported in the 2015 ESC guidelines for the diagnosis and management of pericardial diseases 1.

Causes of Pericarditis

The causes of pericarditis can be categorized into several groups, including:

  • Viral infections: coxsackieviruses, echoviruses, adenoviruses, and influenza viruses are the most common causes of viral pericarditis, as stated in the 2015 ESC guidelines 1
  • Autoimmune disorders: conditions such as lupus, rheumatoid arthritis, and scleroderma can trigger pericardial inflammation, as mentioned in the 2015 ESC guidelines 1
  • Idiopathic factors: about 80-90% of pericarditis cases in developed countries are idiopathic or presumed viral, where no specific cause is identified despite thorough evaluation, as reported in the 2015 ESC guidelines 1
  • Bacterial infections: although less common, bacterial infections such as tuberculosis can cause pericarditis, particularly in developing countries, as noted in the 2015 ESC guidelines 1
  • Post-cardiac injury syndromes: heart surgery, myocardial infarction, or trauma can lead to pericarditis, as discussed in the 2015 ESC guidelines 1
  • Medications: certain medications, including hydralazine, procainamide, and some chemotherapy agents, can induce pericarditis, as mentioned in the 2015 ESC guidelines 1
  • Metabolic causes: uremia in patients with kidney failure can cause pericarditis, as reported in the 2015 ESC guidelines 1
  • Radiation therapy: radiation therapy to the chest area can cause acute or delayed pericarditis, as noted in the 2017 study on cardiovascular complications of cancer therapy 1

Importance of Identifying Causes

Understanding the causes of pericarditis is crucial for guiding appropriate treatment, which typically includes anti-inflammatory medications like NSAIDs and colchicine, along with treating any underlying condition, as recommended in the 2015 ESC guidelines 1.

Recent Guidelines

The 2015 ESC guidelines for the diagnosis and management of pericardial diseases provide a comprehensive approach to the diagnosis and treatment of pericarditis, including the identification of high-risk features and the use of colchicine to prevent recurrences, as stated in the guidelines 1.

Conclusion Not Applicable

As per the instructions, no conclusion section is provided. The information is presented in a clear and concise manner, with a focus on the most recent and highest quality evidence, as reported in the 2015 ESC guidelines 1.

From the Research

Causes of Pericarditis

The most common causes of pericarditis are:

  • Idiopathic or viral, which are the leading causes in North America and Western Europe 2, 3
  • Tuberculosis, which is the most common cause in endemic areas 2, 3, 4
  • Post-cardiac injury syndromes, such as pericarditis after cardiac procedures or operations 2, 3
  • Bacterial pericarditis, which can occur through direct infection, spread from an intrathoracic focus, or hematogenous dissemination 4
  • Systemic inflammatory diseases, cancer, and other non-infectious causes 3, 5

Specific Causes

Some specific causes of pericarditis include:

  • Viral infections, such as Echo-virus and Coxsackie 5
  • Bacterial infections, such as Staphylococcus, Streptococcus, Haemophilus, and Mycobacterium tuberculosis 4
  • Mycobacterium avium-intracellulare infection in patients with AIDS 4

Geographic Variation

The causes of pericarditis can vary by geographic location:

  • In North America and Western Europe, idiopathic and viral causes are most common 2, 3
  • In endemic areas, tuberculosis is the most common cause 2, 3, 4

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Bacterial pericarditis: diagnosis and management.

American journal of cardiovascular drugs : drugs, devices, and other interventions, 2005

Research

Recurrent pericarditis: infectious or autoimmune?

Autoimmunity reviews, 2008

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.