Last reviewed: 22 Feb 2023
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.
Differentials
- Myocardial infarction or ischemia
- Pulmonary embolism
- Pneumonia
More DifferentialsGuidelines
- 2015 ESC Guidelines for the diagnosis and management of pericardial diseases
- 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction
More GuidelinesPatient leaflets
Pericarditis
More Patient leafletsVideos
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