Fibrinous pericarditis, gross specimen. Fibrinous pericarditis is one of the most common forms of acute pericarditis. It can be caused by acute myocardial infarction (heart attack), post-infarction syndrome, uraemia, chest radiation, rheumatic fever, systemic lupus erythematosus, and trauma (including cardiac surgery). The pericardial surface is dry with a coarse granular appearance caused by fibrinous exudate as seen in this image. Over time, the fibrinous exudate may become organised or undergo lysis with resolution of the inflammation.