Overview of Pericarditis
The pericardium is a thin layer of specialized tissue that covers the outer surfaces of the heart. This tissue helps to anchor the heart in place, prevents excessive movement of the heart in the chest when body position changes, protects the heart from infections and tumors that develop in and may spread from nearby tissues, and may help keep the heart from enlarging. Inflammation of the pericardium is called pericarditis. Pericarditis frequently causes a characteristic chest pain that usually compels one to seek medical attention.
There are many causes of pericarditis, including infection, kidney failure, metastatic disease, some medications, and radiation therapy. Recent viral infection often precedes pericarditis in young, otherwise healthy patients. In idiopathic pericarditis, no clear cause is determined.
Patients who have suffered a heart attack (myocardial infarction) may develop pericarditis over subsequent days or weeks. Kidney failure caused by the buildup of certain toxins in the body also can lead to pericarditis. Cells from tumors in other parts of the body occasionally spread (metastasize) to the pericardium, leading to irritation and inflammation. Radiation therapy (used to treat cancer) can cause pericarditis also. Pericarditis can develop in patients with diseases in which the immune system becomes pathologically overactive, such as rheumatoid arthritis and lupus. Tuberculosis was a relatively common cause of pericarditis in the past, but this is now rare.
Some medications can trigger an immune response that causes pericarditis. These medications include the antituberculosis medicine isoniazid (Nydrazid®), the hypertension and heart failure medicine hydralazine (Apresoline®), the antibiotic penicillin, the antiarrhythmic agent procainamide (Procanbid®, Pronestyl®), and the seizure medication phenytoin (Dilantin®).