Pericarditis and Myocarditis

Pericarditis can be caused by cancer chemotherapeutic agents, such as dantrolene, hydralazine, isoniazid, minoxidil, procainamide, phenytoin, and anticoagulants. Pericardium is defined as a double membrane that covers the heart and can be involved in infective and non-infective disorders. Pericarditis may cause severe chest pain in the retrosternal or left precordial area. Radiation to the chest may rarely cause pericarditis. Occasionally, the pain radiates to the trapezius ridge, a radiation that does not occur with angina, but it may also radiate to the neck or left arm and may stimulate angina or myocardial infarction. At times, the pain is localized to the upper epigastrium and left upper quadrant. Typical features of pain include a sharp, pleuritic pain that increases with deep inspiration, coughing, sneezing, or worsening of pain when lying down. The sharp pain that occurs in bed typically is relieved immediately by sitting and leaning forward or on standing; pain recurs with recumbency.