Pericarditis epidemiology and demographics


 * Associate Editor-In-Chief: Varun Kumar, M.B.B.S.

Overview
Pericarditis in developed countries are usually due to viral infections such as echovirus and coxsackie virus, while in developing countries it is usually secondary to tuberculosis or HIV infection. The incidence of pericarditis following MI has greatly reduced with the use of early thrombolytic agents and revascularization.

Epidemiology in Developed Countries
Pericarditis in developed countries is most often of viral origin  .Pericarditis most often affects men aged 20 - 50. It usually follows respiratory infections, most commonly echovirus or coxsackie virus. In children, it is most commonly caused by adenovirus or coxsackie virus. The incidence and prevalence of viral pericarditis varies with season and region.

Epidemiology in Developing Countries
Pericarditis secondary to HIV and tuberculosis is one of the major cause of acute pericarditis in developing countries. Tuberculous pericarditis, caused by Mycobacterium tuberculosis, is found in approximately 1% of all autopsied cases of TB and in 1% to 2% of instances of pulmonary TB. It accounted for 69.5% (162 of 233) of cases referred for diagnostic pericardiocentesis in a study in Western Cape Province of South Africa while the same accounts for 4% of cases in developed countries.

Age
Pericarditis is more frequently seen among adolescents than young adults or children. However, no differences in etiology, clinical course, and prognosis were observed across different age groups of patients with moderate or large pericardial effusions.

Impact of Gender
Pericarditis is seen more frequently among males than females.

Disorders Associated with Pericarditis
Pericarditis can be associated with diseases such as autoimmune disorders, cancer, hypothyroidism, and kidney failure. It occurs in approximately in 13 percent of patients who are on maintenance hemodialysis. Hyperuricemia due to inadequate dialysis or fluid overload may be the reason for pericarditis.

Pericarditis Following Myocardial Infarction
In one series, about 1% of STEMI patients presenting to emergency department were seen to have pericarditis. The use of thrombolytic agents and early revascularization have greatly reduced the incidence of both early postinfarction pericarditis and Dressler's syndrome. Patients presenting to the emergency department with pericarditis account for up to 5% of those with nonischemic chest pain.