Pericarditis

Pericarditis symptoms include sharp, severe retrosternal chest pain worse with inspiration and a supine position.

The classic physical finding is a pericardial friction rub. A low-grade fever may be present.

Diagnostic signs include widespread electrocardiographic ST elevation or PR depression and a new or worsening pericardial effusion on echocardiography; blood tests generally suggest systemic inflammation.

Treatment is directed at any underlying systemic disorder. Idiopathic or viral pericarditis typically responds to nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine. Additional treatments (e.g., corticosteroids, interleukin [IL]-1 antagonists) may be required. In nonidiopathic cases, the underlying cause should be treated.

Complications include chronic recurrent pericarditis, cardiac tamponade, and constrictive pericarditis.

Pericarditis is an inflammation of the pericardium. The acute form is defined as new-onset inflammation lasting <4-6 weeks. It is characterized clinically by pleuritic chest pain or equivalent (typically sharp, relieved by sitting up or leaning forward) with at least one additional finding; pericardial rub, ECG changes, elevated inflammatory biomarkers, cardiac imaging evidence of pericardial effusion or inflammation.[1]Wang TKM, Klein AL, Cremer PC, et al. 2025 concise clinical guidance: an ACC expert consensus statement on the diagnosis and management of pericarditis: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2025 Dec 23;86(25):2691-719. https://www.jacc.org/doi/10.1016/j.jacc.2025.05.023 http://www.ncbi.nlm.nih.gov/pubmed/40767817?tool=bestpractice.com

This topic covers both acute and recurrent pericarditis in adults. Children are not covered in this topic.