Acute pericarditis is a clinical diagnosis. Aspects of the clinical history and presentation, physical examination, and ECG need to be combined in order to make the diagnosis. The diagnosis is confirmed in the presence of at least 2 of the 4 clinical criteria: typical chest pain, pericardial friction rub, widespread ST elevation, and pericardial effusion.
Because most cases of acute pericarditis follow a benign course, particularly for common causes of acute pericarditis in countries in which tuberculosis has a low prevalence, it is not essential to determine the aetiology in all patients. In addition, there is a relatively low yield of diagnostic investigations. However, patients should be screened for high-risk features that portend an increased risk of complications.
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