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Pathology – Pericarditis
Definition • Inflammation of the pericardium.
Epidemiology: Rare occurrence.
Aetiology
Infections are a prevalent etiology, which may be viral (coxsackievirus, Epstein-Barr virus, human immunodeficiency virus), bacterial (extension from pneumonia, acute rheumatic fever, tuberculosis), or fungal.
• Full-thickness acute myocardial infarction induces pericarditis affecting the region above the infarct. Other miscellaneous reasons encompass severe renal failure ('uraemic' pericarditis), hypothyroidism, multisystem autoimmune illnesses (e.g., rheumatoid arthritis, systemic lupus erythematosus), cardiac surgery, radiation, malignant infiltration, and certain pharmaceuticals.
Pathogenesis
Injury to the pericardium elicits an inflammatory reaction.
Presentation
• Central chest pain exacerbated by inhalation or supine position and alleviated by an upright posture. • A significant pericardial effusion may induce dyspnea.
Macroscopy
• The pericardial surface of the heart exhibits roughness attributed to inflammatory exudate. • Strands of fibrinous material may be observed between the two pericardial surfaces. • The exudate may be purulent if linked to bacterial infection. A concomitant pericardial effusion may be observed. Histopathology • The pericardium is infiltrated by inflammatory cells, frequently accompanied by fibrin deposition. • Malignant cells may be observed in instances of malignant infiltration.
Prognosis: Infective pericarditis frequently resolves with suitable therapy. Pericarditis linked to an acute myocardial infarction is determined by the consequences of the infarction. Uraemic pericarditis indicates severe renal failure, which carries a significant risk of mortality. Malignant pericarditis typically indicates substantial metastatic disease and an unfavorable prognosis. Any etiology of pericarditis may result in a reactive pericardial effusion, which, if substantial, necessitates immediate drainage to avert cardiac tamponade.
Definition • Inflammation of the pericardium.
Epidemiology: Rare occurrence.
Aetiology
Infections are a prevalent etiology, which may be viral (coxsackievirus, Epstein-Barr virus, human immunodeficiency virus), bacterial (extension from pneumonia, acute rheumatic fever, tuberculosis), or fungal.
• Full-thickness acute myocardial infarction induces pericarditis affecting the region above the infarct. Other miscellaneous reasons encompass severe renal failure ('uraemic' pericarditis), hypothyroidism, multisystem autoimmune illnesses (e.g., rheumatoid arthritis, systemic lupus erythematosus), cardiac surgery, radiation, malignant infiltration, and certain pharmaceuticals.
Pathogenesis
Injury to the pericardium elicits an inflammatory reaction.
Presentation
• Central chest pain exacerbated by inhalation or supine position and alleviated by an upright posture. • A significant pericardial effusion may induce dyspnea.
Macroscopy
• The pericardial surface of the heart exhibits roughness attributed to inflammatory exudate. • Strands of fibrinous material may be observed between the two pericardial surfaces. • The exudate may be purulent if linked to bacterial infection. A concomitant pericardial effusion may be observed. Histopathology • The pericardium is infiltrated by inflammatory cells, frequently accompanied by fibrin deposition. • Malignant cells may be observed in instances of malignant infiltration.
Prognosis: Infective pericarditis frequently resolves with suitable therapy. Pericarditis linked to an acute myocardial infarction is determined by the consequences of the infarction. Uraemic pericarditis indicates severe renal failure, which carries a significant risk of mortality. Malignant pericarditis typically indicates substantial metastatic disease and an unfavorable prognosis. Any etiology of pericarditis may result in a reactive pericardial effusion, which, if substantial, necessitates immediate drainage to avert cardiac tamponade.
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