Pericarditis

Last reviewed: 3 Jun 2022
Last updated: 29 Apr 2021

Summary

Definition

History and exam

Key diagnostic factors

  • chest pain
  • pericardial rub
More key diagnostic factors

Other diagnostic factors

  • fever
  • myalgias
  • signs of right-sided heart failure
Other diagnostic factors

Risk factors

  • male sex
  • age 20 to 50 years
  • transmural MI
  • cardiac surgery
  • neoplasm
  • viral and bacterial infections
  • uremia or on dialysis
  • systemic autoimmune disorders
  • pericardial injury
  • mediastinal radiation
More risk factors

Diagnostic investigations

1st investigations to order

  • ECG
  • serum troponin
  • pericardial fluid/blood culture
  • ESR
  • CRP
  • serum BUN
  • CBC
  • chest x-ray
  • echocardiography
More 1st investigations to order

Investigations to consider

  • chest CT or cardiac MRI
  • pericardiocentesis/biopsy
More investigations to consider

Treatment algorithm

INITIAL

at initial presentation

ACUTE

tamponade or symptomatic effusion

purulent

non-purulent

ONGOING

recurrent disease

Contributors

Authors

Katherine Wu, MD

Associate Professor of Medicine

Division of Cardiology

Johns Hopkins Medical Institutions

Baltimore

MD

Disclosures

KW declares that she has no competing interests.

Peer reviewers

Victor Ferrari, MD

Associate Professor of Medicine

Cardiovascular Division

University of PA Medical Center

Philadelphia

PA

Disclosures

VF declares that he has no competing interests.

Shrilla Banerjee, MBMD, MRCP

Consultant Cardiologist

East Surrey Hospital

Surrey and Sussex NHS Trust

Redhill

UK

Disclosures

SB declares that she has no competing interests.

  • Pericarditis images
  • Differentials

    • Myocardial infarction or ischemia
    • Pulmonary embolism
    • Pneumonia
    More Differentials
  • Guidelines

    • 2015 ESC Guidelines for the diagnosis and management of pericardial diseases
    • 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction
    More Guidelines
  • Patient leaflets

    Pericarditis

    More Patient leaflets
  • Videos

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    How to perform an ECG: animated demonstration

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