Summary
Definition
History and exam
Key diagnostic factors
- chest pain
- pericardial rub
Other diagnostic factors
- fever
- myalgias
- signs of right-sided heart failure
Risk factors
- male sex
- age 20 to 50 years
- transmural myocardial infarction (MI)
- cardiac surgery
- neoplasm
- viral and bacterial infections
- uremia or on dialysis
- systemic autoimmune disorders
- pericardial injury
- mediastinal radiation
Diagnostic tests
1st tests to order
- ECG
- serum troponin
- pericardial fluid/blood culture
- erythrocyte sedimentation rate (ESR)
- CRP
- serum BUN
- CBC
- chest x-ray
- echocardiography
Tests to consider
- chest CT or cardiac MRI
- pericardiocentesis/biopsy
Treatment algorithm
suspected pericarditis
purulent
non-purulent
recurrent disease
Contributors
Expert advisers
Antonio Abbate, MD, PhD
Professor of Cardiology
Division of Cardiovascular Medicine
University of Virginia
Charlottesville
VA
Disclosures
AA has received grant support and consultant fees from Applied Clinical Intel, Astra Zeneca, Cromos Pharma, Eli Lilly, Implicit Biosciences, Janssen, Kiniksa, Merck, Novartis, Novo Nordisk, Olatec, R-Pharm, and Serpin Pharma.
Acknowledgements
BMJ Best Practice would like to gratefully acknowledge Dr Katherine Wu MD, a previous contributor to this topic.
Disclosures
KW declares that she has no competing interests.
Peer reviewers
Susan Denfield, MD
Associate Professor of Pediatrics
Division of Pediatric Cardiology
Texas Children's Hospital
Houston
TX
Declarações
SD declares that she has no competing interests.
Shrilla Banerjee, MBMD, MRCP
Consultant Cardiologist
East Surrey Hospital
Surrey and Sussex NHS Trust
Redhill
UK
Declarações
SB declares that she has no competing interests.
Créditos aos pareceristas
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Declarações
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Referências
Principais artigos
Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 2015 Nov 7;36(42):2921-64.Texto completo Resumo
Chiabrando JG, Bonaventura A, Vecchié A, et al. Management of acute and recurrent pericarditis: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020 Jan 7;75(1):76-92.Texto completo Resumo
Gulati M, Levy PD, Mukherjee D, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the evaluation and diagnosis of chest pain: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2021 Nov 30;144(22):e368-e454.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Pulmonary embolism (PE)
- Myocardial infarction or ischemia
- Pneumonia
Mais Diagnósticos diferenciaisDiretrizes
- 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for the management of patients with acute coronary syndromes
- 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR guideline for the evaluation and diagnosis of chest pain
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