Any process that leads to injury or inflammation of the pericardium and/or inhibits appropriate lymphatic drainage of the fluid from the<unk>  cavity leads to fluid accumulation.<unk> s can be found in all populations worldwide but the predominant etiology has changed over time, varying depending on the age, location, and comorbidities of the population in question. Out of all the numerous causes of<unk> , some of the leading causes are inflammatory, infectious, neoplastic and traumatic. These causes can be categorized into various classes, but an easy way to understand them is dividing them into inflammatory versus non-inflammatory. A<unk>  due to pericarditis Inflammatory # Infectious: #* Viral: coxsackie A and B viruses, HIV (seen in 5-43% of HIV patients), hepatitis viruses, parvovirus B19 #* Bacterial: Mycobacterium (tuberculosis), gram positive cocci (Streptococcus, Staphylococcus), Mycoplasma, Neisseria (meningitides, gonorrhea), Coxiella burnetii. Tuberculosis is the leading cause of<unk>  in the developing world, with the mortality rate ranging from 17-40%. #* Fungal: Histoplasma, Candida #* Protozoal: Echinococcus, Trichinosis, Toxoplasma # Cardiac injury syndromes: Heart surgery (postpericardiotomy syndrome), post-myocardial infarction (Dressler's syndrome), coronary interventions such as drug eluting stents. Post-cardiac surgery<unk> s contribute to 54% of total<unk> s in the pediatric population. # Cardiac inflammation: idiopathic pericarditis is the most common inflammatory cause of<unk>  in the United States. # Autoimmune: lupus, rheumatoid arthritis, Sjögren syndrome, scleroderma, Dressler's syndrome, sarcoidosis # Drug hypersensitivity/ side effects: Chemotherapy drugs (doxorubicin and cyclophosphamide), Minoxidil # Others: kidney failure, uremia Non-Inflammatory # Neoplastic:<unk> s may present as primary manifestations of underlying malignancy. #* Primary tumor: the most common primary<unk>  tumor is mesothelioma. Various imaging appearances such as solid and cystic components could be encountered on CT scan on those with mesothelioma. Other less common primary tumors are sarcoma, lymphoma, and primitive neuroectodermal tumour. #* Secondary cancers: that have spread to the pericardium such as breast and lung cancer.<unk>  irregular thickening and/or nodularity, focal, or diffuse FDG uptake on PET scan and lack of preserved fat plane with an adjacent tumor are strongly suggestive of cancer spread from other parts of the body. # Metabolic: hypothyroidism (myxedema coma), severe protein deficiency # Traumatic: penetrating or blunt chest trauma, aortic dissection # Reduced lymphatic drainage: congestive heart failure, nephrotic syndrome
Pericardial effusion
Pericarditis
Cardiac tamponade
Subpulmonic effusion
Acute pericarditis
Pleural effusion
Constrictive pericarditis
Pneumopericardium