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.
Divulgaciones
KW declares that she has no competing interests.
Revisores por pares
Susan Denfield, MD
Associate Professor of Pediatrics
Division of Pediatric Cardiology
Texas Children's Hospital
Houston
TX
Divulgaciones
SD declares that she has no competing interests.
Shrilla Banerjee, MBMD, MRCP
Consultant Cardiologist
East Surrey Hospital
Surrey and Sussex NHS Trust
Redhill
UK
Divulgaciones
SB declares that she has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
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 Resumen
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 Resumen
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 Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Pulmonary embolism (PE)
- Myocardial infarction or ischemia
- Pneumonia
Más DiferencialesGuías de práctica clínica
- 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
Más Guías de práctica clínicaVideos
Venepuncture and phlebotomy: animated demonstration
How to perform an ECG: animated demonstration
Más vídeosFolletos para el paciente
Pericarditis
Más Folletos para el paciente
Inicie sesión o suscríbase para acceder a todo el BMJ Best Practice
El uso de este contenido está sujeto a nuestra cláusula de exención de responsabilidad