{ "schemaVersion": 2, "eyebrow": "Cardiology", "title": "Pericarditis", "summary": "Manage pericarditis by first excluding tamponade and high-risk secondary causes, then confirming active pericardial inflammation, treating uncomplicated inflammatory disease, and escalating recurrent, constrictive, purulent, tuberculous, or malignant phenotypes to targeted imaging, drainage, cause-directed therapy, or expert surgical care.", "seoDescription": "Physician guide to pericarditis diagnosis, risk triage, imaging, anti-inflammatory treatment, recurrent disease, tamponade, and constriction.", "clinicalQuestion": "How should physicians triage, confirm, phenotype, treat, and monitor acute or recurrent pericarditis?", "specialty": "Cardiology", "audience": "U.S. physicians and medical trainees", "tags": [ "acute pericarditis", "recurrent pericarditis", "cardiac tamponade", "pericardial effusion", "constrictive pericarditis", "colchicine", "cardiac magnetic resonance" ], "keyTakeaways": [ "Treat hemodynamic compromise or suspected tamponade as an urgent echocardiographic and drainage decision, not as routine outpatient pericarditis. [4][12]", "Establish acute pericarditis from a compatible presentation plus objective clinical, ECG, inflammatory, effusion, or CMR evidence; CMR pericardial edema or late gadolinium enhancement supports active inflammation. [11][17]", "Reserve extensive etiologic testing for patients whose epidemiology, history, presentation, or echocardiographic findings suggest tuberculosis, purulent infection, malignancy, or systemic disease. [22][23]", "For inflammatory acute or recurrent disease, anti-inflammatory therapy is foundational; colchicine is an effective adjunct for acute disease and is used to reduce recurrences. [1][12][13][21]", "Persistent constrictive physiology, effusive-constrictive disease, or medically refractory recurrent disease warrants multimodality imaging and multidisciplinary assessment at a center experienced in pericardiectomy. [9][10]" ], "sections": [ { "id": "triage-immediate-threats", "eyebrow": "First decision", "heading": "Identify tamponade and patients needing urgent inpatient evaluation", "intro": "Separate a stable inflammatory syndrome from hemodynamic compromise or a high-risk secondary process.", "paragraphs": [ "Obtain urgent transthoracic echocardiography when pericarditis is accompanied by hypotension, tachycardia, elevated jugular venous pressure, pulsus paradoxus, syncope, progressive dyspnea, or a suspected moderate-to-large effusion. Tamponade results from pericardial fluid accumulation that impairs diastolic cardiac filling; the immediate management pathway is drainage rather than escalation of outpatient anti-inflammatory therapy. [4][12]", "Admit or expedite cardiology evaluation when the presentation raises concern for purulent, tuberculous, neoplastic, or systemic inflammatory pericarditis, because these etiologies change the role of pericardial fluid analysis, biopsy, antimicrobial or oncologic treatment, and prognosis. Early echocardiography and a low threshold for diagnostic pericardiocentesis are particularly important when septic pericarditis is possible. [3][22][23]", "Use the initial history to direct this branch: recent cardiac surgery, percutaneous cardiac intervention, radiation exposure, acute myocardial infarction, advanced kidney failure, known cancer, tuberculosis exposure or epidemiologic risk, and systemic autoimmune features each increase the likelihood of secondary pericarditis. [6][23]" ], "bullets": [ "Suspected tamponade: perform urgent echocardiography and arrange pericardial drainage according to hemodynamic status. [4][12]", "Suspected septic pericarditis: obtain early echocardiography and pursue diagnostic pericardiocentesis without delaying evaluation for microbiologic confirmation. [3]", "Known cancer with a new effusion: evaluate for malignant or treatment-related pericardial disease rather than presuming idiopathic inflammation. [23]", "Prior radiation, cardiac surgery, or invasive cardiac procedure: consider secondary pericarditis and later constrictive disease in follow-up. [6][23]" ], "subsections": [], "table": { "caption": "Initial triage features that change the pericarditis pathway. [3][4][22][23]", "columns": [ "Finding or context", "Immediate action", "Why it changes management" ], "rows": [ [ "Hypotension, pulsus paradoxus, elevated jugular venous pressure, or rapidly progressive dyspnea", "Urgent transthoracic echocardiography; prepare for drainage if tamponade is present. [4]", "Suggests impaired diastolic filling from tamponade. [4]" ], [ "Fever or systemic toxicity with effusion", "Early echocardiography and low threshold for diagnostic pericardiocentesis. [3]", "Purulent pericarditis requires prompt microbiologic diagnosis and treatment. [3][22]" ], [ "Tuberculosis risk, cancer, autoimmune manifestations, renal failure, radiation, or recent cardiac injury", "Use targeted etiologic testing and specialty-directed management. [22][23]", "A specific cause may require treatment beyond anti-inflammatory therapy. [22][23]" ] ] } }, { "id": "confirm-active-pericarditis", "eyebrow": "Diagnostic confirmation", "heading": "Confirm active pericardial inflammation and assess myocardial involvement", "intro": "Do not label unexplained chest pain as pericarditis without objective corroboration.", "paragraphs": [ "For a definite clinical diagnosis, use a compatible presentation of chest pain and/or dyspnea plus more than one additional criterion: pericardial friction rub; PR depression and/or diffuse ST-segment elevation on ECG; elevated C-reactive protein; new or worsening pericardial effusion; or pericardial edema and/or late gadolinium enhancement on cardiac magnetic resonance imaging. A compatible presentation with only one additional criterion supports possible rather than definite pericarditis; symptoms without an additional criterion make the diagnosis unlikely. [11]", "At presentation, obtain ECG, CRP, and transthoracic echocardiography to document electrical, inflammatory, and effusion evidence and to assess for hemodynamic consequences. ECG and imaging abnormalities, inflammatory biomarkers, a friction rub, and pericardial fluid or inflammation on echo, CT, or MRI are all used as objective evidence in contemporary pericarditis assessment. [2][20]", "Use cardiac MRI when the diagnosis remains uncertain after clinical evaluation, ECG, inflammatory biomarkers, and echocardiography, or when recurrent symptoms require evidence of ongoing inflammation before intensifying immunomodulatory treatment. Pericardial delayed enhancement is described as the most sensitive diagnostic method for acute pericarditis, while pericardial edema or late gadolinium enhancement supports active disease. [11][17]", "Measure cardiac troponin when myocardial involvement is clinically plausible. Elevated myocardial biomarkers, new arrhythmia on ECG or telemetry, echocardiographic abnormalities, and cardiac MRI abnormalities are features used to identify myocarditis in patients with suspected myopericarditis; their presence should shift assessment beyond isolated pericardial disease. [16][20]" ], "bullets": [ "CRP elevation supports active inflammation but is not sufficient alone to establish pericarditis. [11]", "A normal or nondiagnostic echocardiogram does not exclude active pericardial inflammation; use CMR selectively when confirmation will change management. [17][18]", "Document the initial ECG, CRP, troponin, echocardiographic findings, and CMR abnormalities when present, because follow-up testing should target abnormalities found at baseline. [20]" ], "subsections": [ { "heading": "Classify the clinical course before changing treatment", "paragraphs": [ "Classify symptoms continuing for at least 4 weeks but less than 3 months without remission as incessant pericarditis; classify recurrence only after a documented first episode and a symptom-free interval of at least 4 weeks; classify disease lasting longer than 3 months as chronic. This distinction prevents mislabeling incompletely controlled initial inflammation as a recurrence and supports an appropriately prolonged anti-inflammatory strategy. [13]" ], "bullets": [] } ], "table": { "caption": "Tests that establish disease activity or alter the diagnostic branch. [11][16][17][20]", "columns": [ "Test", "Actionable result", "Next decision" ], "rows": [ [ "12-lead ECG", "PR depression and/or widespread ST-segment elevation supports pericarditis. [11]", "Integrate with symptoms and other criteria; assess rhythm abnormalities if myocardial involvement is suspected. [20]" ], [ "C-reactive protein", "Elevation supports active pericardial inflammation. [11]", "Use with clinical findings and follow longitudinally when monitoring inflammatory activity. [20]" ], [ "Transthoracic echocardiography", "New or worsening effusion supports diagnosis; hemodynamic consequences redirect to tamponade management. [11][4]", "Determine urgency of drainage and whether a secondary cause needs invasive sampling. [3][22]" ], [ "Cardiac MRI", "Pericardial edema or late gadolinium enhancement supports active inflammation; delayed enhancement is highly sensitive. [11][17]", "Use to resolve diagnostic uncertainty or document inflammation in recurrent disease. [18]" ], [ "Troponin and myocardial assessment", "Biomarker elevation, arrhythmia, imaging, or echo abnormalities suggest myopericarditis. [20]", "Expand evaluation beyond isolated pericarditis. [16][20]" ] ] } }, { "id": "etiologic-branching", "eyebrow": "Targeted cause search", "heading": "Choose etiologic testing from the risk pattern rather than routinely testing every patient", "intro": "Most first attacks are idiopathic or presumed viral; targeted testing is reserved for presentations in which results change treatment.", "paragraphs": [ "In an uncomplicated first episode without epidemiologic, historical, clinical, or echocardiographic clues to a secondary cause, extensive etiologic testing usually does not alter management. Most cases remain idiopathic or presumed viral even after broad testing, and identifying a causative virus is generally futile because it does not change treatment. [22][23]", "Escalate to a directed search for tuberculosis, purulent infection, malignancy, or systemic inflammatory disease when the presentation is atypical, severe, recurrent, or accompanied by a compatible exposure history, cancer, systemic features, or concerning effusion. The diagnostic objective is to identify conditions in which antimicrobials, cancer-directed therapy, renal replacement optimization, cessation of an offending drug, or systemic immunomodulation may be required. [22][23][24]", "In patients with arthralgia, myalgia, fever, rash, constitutional symptoms, or serositis and prolonged exposure to a potential culprit medication, review the drug timeline and evaluate for drug-induced lupus. Antinuclear antibodies and antihistone antibodies commonly support the diagnosis; stopping the responsible medication generally leads to symptom resolution. [24]" ], "bullets": [ "Tuberculosis: pursue targeted evaluation when epidemiology or systemic findings make it plausible; tuberculosis can progress to constrictive pericarditis. [7][22][23]", "Purulent infection: prioritize fluid sampling and microbiologic diagnosis when septic physiology or a concerning effusion is present. [3][22]", "Cancer: distinguish malignant effusion and cancer-therapy-related disease from idiopathic inflammation. [23]", "Systemic immune disease or drug-induced lupus: use systemic review, medication history, ANA, and antihistone antibodies when the phenotype supports this branch. [23][24]" ], "subsections": [], "table": { "caption": "Etiologic patterns requiring a cause-directed pathway. [3][7][22][23][24]", "columns": [ "Pattern", "Diagnostic emphasis", "Management consequence" ], "rows": [ [ "Septic or toxic presentation with effusion", "Early echocardiography and diagnostic pericardiocentesis. [3]", "Obtain microbiologic diagnosis promptly; do not manage as uncomplicated idiopathic pericarditis. [3][22]" ], [ "Tuberculosis exposure or compatible epidemiology", "Directed tuberculosis evaluation and assessment for constrictive complications. [7][22]", "Requires etiologic therapy and surveillance for constrictive physiology. [7][23]" ], [ "Known malignancy or active cancer therapy", "Assess the effusion for malignant disease and treatment-related injury. [23]", "Cancer-directed evaluation may supersede routine anti-inflammatory management. [23]" ], [ "Autoimmune symptoms or prolonged culprit-drug exposure", "Systemic evaluation; ANA and antihistone antibodies when drug-induced lupus is suspected. [24]", "Withdraw the offending medication and manage the associated systemic disorder. [24]" ] ] } }, { "id": "anti-inflammatory-treatment", "eyebrow": "Inflammatory phenotype", "heading": "Treat uncomplicated acute and recurrent inflammatory pericarditis with anti-inflammatory therapy and colchicine", "intro": "Use anti-inflammatory treatment only after urgent hemodynamic and cause-specific branches have been addressed.", "paragraphs": [ "Anti-inflammatory drugs are the mainstay of treatment for acute and recurrent pericarditis. For recurrent disease, prolonged NSAID therapy is generally used, and colchicine may be added to NSAID therapy or used as monotherapy when NSAID treatment is unsuitable. [12][21]", "For acute pericarditis, colchicine has randomized-trial evidence of effectiveness when added to conventional anti-inflammatory treatment. A cited regimen is colchicine 1 mg/day for 3 months, with or without a 2-mg loading dose; the trial literature also describes guideline-era doses of 2 mg/day for 1 to 2 days as loading treatment. Select dose and loading strategy cautiously rather than defaulting to loading in every patient. [1][13]", "Before prescribing colchicine, review renal, hepatic, gastrointestinal, hematologic, and cardiac comorbidity and review interacting medications. Reported adverse effects include diarrhea, nausea, abdominal pain, elevated transaminases, alopecia, and less commonly bone marrow suppression, hepatotoxicity, and myotoxicity; severe renal, gastrointestinal, hepatic, or cardiac disorders and blood dyscrasias are listed contraindications in the cited review. [13]", "In recurrent disease, distinguish persistent inflammation from noninflammatory chest pain before extending or escalating therapy. Reassess symptoms, CRP, ECG, echocardiography, and cardiac MRI when needed; MRI evidence of active pericardial edema or late gadolinium enhancement supports an inflammatory target for treatment. [11][17][18]" ], "bullets": [ "Acute inflammatory episode: use an anti-inflammatory drug regimen plus colchicine when no cause-specific contraindication or alternative pathway is present. [1][12][13]", "Colchicine monitoring: ask specifically about gastrointestinal symptoms and assess for hepatic, hematologic, or muscle toxicity when clinically indicated. [13]", "Recurrent symptoms with no objective inflammatory evidence: reconsider the diagnosis before adding immunomodulatory therapy. [11][17]", "Refractory recurrent pericarditis: consider a multidisciplinary pathway; anti-IL-1 therapies are identified as targeted therapeutics for autoinflammatory recurrent disease. [10]" ], "subsections": [ { "heading": "When to move beyond conventional therapy", "paragraphs": [ "Refer patients with refractory recurrent pericarditis despite optimal medical therapy for expert evaluation, particularly when multimodality imaging documents persistent inflammation or complications. Contemporary imaging literature identifies targeted anti-IL-1 therapy as a therapeutic advance in autoinflammatory pericarditis, but agent selection, dosing, screening, and monitoring should follow specialist and current product-specific guidance. [10][18]" ], "bullets": [] } ], "table": { "caption": "Treatment selection for the inflammatory pericarditis phenotype. [1][10][12][13][21]", "columns": [ "Clinical setting", "Treatment action", "Key limitation or monitoring issue" ], "rows": [ [ "Uncomplicated acute pericarditis", "Use anti-inflammatory therapy; add colchicine, with a cited 1 mg/day for 3 months regimen. [1][12][13]", "Assess gastrointestinal tolerance and contraindicating renal, hepatic, gastrointestinal, cardiac, or hematologic disorders. [13]" ], [ "Recurrent inflammatory pericarditis", "Use a prolonged NSAID course; add colchicine or use colchicine monotherapy when NSAIDs are unsuitable. [21]", "Confirm active inflammation with clinical findings, CRP, and selective CMR before escalation. [11][17]" ], [ "Refractory recurrent disease despite optimal therapy", "Refer for multidisciplinary assessment and consideration of targeted anti-IL-1 therapy. [10]", "Do not bypass evaluation for secondary infection, malignancy, systemic disease, or constrictive physiology. [22][23]" ] ] } }, { "id": "effusion-constriction-follow-up", "eyebrow": "Complication management", "heading": "Recognize effusive-constrictive and chronic constrictive disease before symptoms are attributed to recurrent inflammation", "intro": "Persistent congestion or impaired filling after an effusion changes the problem from simple inflammation to a structural-hemodynamic assessment.", "paragraphs": [ "Consider effusive-constrictive pericarditis when clinical hemodynamic compromise persists in the setting of pericardial fluid because the visceral pericardium can continue to compress the heart despite the effusion. This phenotype requires imaging-based hemodynamic assessment and should not be managed solely by repeated empiric anti-inflammatory courses. [9][10]", "Evaluate suspected constrictive pericarditis with echocardiography and complementary cardiac CT or MRI when anatomy, inflammation, and constrictive physiology remain uncertain. Multimodality imaging is specifically relevant for recurrent, transient constrictive, and effusive-constrictive pericarditis and helps distinguish potentially inflammatory disease from chronic or irreversible constriction. [10][14][18]", "For chronic or irreversible constrictive pericarditis, and for refractory recurrent pericarditis despite optimal medical therapy, refer for multidisciplinary pericardiectomy assessment. When surgery is appropriate, radical pericardiectomy on cardiopulmonary bypass is preferred if feasible, and procedures should be performed at high-volume centers with appropriate expertise. [10]", "Follow patients according to their initial objective abnormalities. A structured approach includes repeat CRP and cardiac biomarkers and repeating ECG, Holter monitoring, echocardiography, or MRI when the corresponding baseline study was abnormal; longitudinal visits at 3 months, 12 months, and annually are used in a myocarditis/pericarditis follow-up protocol. [20]" ], "bullets": [ "Persistent right-sided congestion or diastolic heart-failure physiology: evaluate for constriction rather than assuming recurrent inflammatory pain. [7][10]", "After an effusion with persistent hemodynamic findings: consider effusive-constrictive pericarditis. [9]", "Documented chronic or irreversible constriction: refer to a high-volume center for pericardiectomy evaluation. [10]", "Baseline abnormal ECG, troponin, echo, Holter, or MRI: repeat the abnormal modality during follow-up rather than using a one-size-fits-all testing schedule. [20]" ], "subsections": [], "table": { "caption": "Complication-directed follow-up and escalation. [7][9][10][20]", "columns": [ "Clinical problem", "Assessment", "Escalation" ], "rows": [ [ "Persistent hemodynamic impairment with effusion", "Assess for effusive-constrictive pericarditis using imaging and hemodynamic evaluation. [9][10]", "Avoid treating persistent compression as uncomplicated recurrent inflammation. [9]" ], [ "Suspected constrictive physiology", "Use echocardiography and complementary CT or MRI when needed. [10][14]", "Determine whether disease is transient/inflammatory or chronic/irreversible. [10]" ], [ "Chronic or irreversible constriction", "Multidisciplinary surgical evaluation. [10]", "Pericardiectomy at a high-volume center; radical resection on cardiopulmonary bypass is preferred if feasible. [10]" ], [ "Prior myocardial or rhythm abnormality", "Repeat relevant biomarker, ECG, Holter, echo, or MRI testing during follow-up. [20]", "Monitor for persistent or recurrent myocardial involvement. [20]" ] ] } } ], "faq": [], "references": [ { "number": 1, "title": "A Randomized Trial of Colchicine for Acute Pericarditis", "detail": "www.nejm.org", "url": "https://www.nejm.org/doi/full/10.1056/NEJMoa1208536", "authors": "www.nejm.org", "host": "www.nejm.org" }, { "number": 2, "title": "Artificial intelligence based multimodal fusion of electronic medical ...", "detail": "heart.bmj.com", "url": "https://heart.bmj.com/content/heartjnl/early/2026/08/19/heartjnl-2025-327090.full.pdf", "authors": "heart.bmj.com", "host": "heart.bmj.com" }, { "number": 3, "title": "Systematic review of culture-confirmed septic pericarditis in systemic ...", "detail": "lupus.bmj.com", "url": "https://lupus.bmj.com/content/13/1/e002004", "authors": "lupus.bmj.com", "host": "lupus.bmj.com" }, { "number": 4, "title": "Haemorrhagic Mycobacterium avium complex pericarditis ...", "detail": "casereports.bmj.com", "url": "https://casereports.bmj.com/content/16/7/e255237", "authors": "casereports.bmj.com", "host": "casereports.bmj.com" }, { "number": 5, "title": "Colchicine as First-Choice Therapy for Recurrent Pericarditis: Results of the CORE (COlchicine for REcurrent pericarditis) Trial | Cardiology | JAMA Internal Medicine | JAMA Network", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486705", "authors": "jamanetwork.com", "host": "jamanetwork.com" }, { "number": 6, "title": "Pericarditis - 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Verify recommendations against current guidance and patient-specific factors.", "citations": [ { "number": 1, "title": "A Randomized Trial of Colchicine for Acute Pericarditis", "detail": "www.nejm.org", "url": "https://www.nejm.org/doi/full/10.1056/NEJMoa1208536", "authors": "www.nejm.org", "host": "www.nejm.org", "snippet": "Colchicine is effective for the treatment of recurrent pericarditis. Current guidelines recommend colchicine doses of 2 mg per day for 1 to 2", "score": 0.5843666 }, { "number": 2, "title": "Artificial intelligence based multimodal fusion of electronic medical ...", "detail": "heart.bmj.com", "url": "https://heart.bmj.com/content/heartjnl/early/2026/08/19/heartjnl-2025-327090.full.pdf", "authors": "heart.bmj.com", "host": "heart.bmj.com", "snippet": "Current diagnostic criteria for pericarditis rely on a combina- tion of clinical findings, electrocardiographic changes, biomarkers and", "score": 0.55275756 }, { "number": 3, "title": "Systematic review of culture-confirmed septic pericarditis in systemic ...", "detail": "lupus.bmj.com", "url": "https://lupus.bmj.com/content/13/1/e002004", "authors": "lupus.bmj.com", "host": "lupus.bmj.com", "snippet": "Early echocardiography and a low threshold for diagnostic pericardiocentesis are essential to prevent fatal delay.", "score": 0.3953682 }, { "number": 4, "title": "Haemorrhagic Mycobacterium avium complex pericarditis ...", "detail": "casereports.bmj.com", "url": "https://casereports.bmj.com/content/16/7/e255237", "authors": "casereports.bmj.com", "host": "casereports.bmj.com", "snippet": "Cardiac tamponade is a syndrome caused by an accumulation of fluid in the pericardial sac (pericardial effusion) that is characterised by resultant diastolic", "score": 0.33144477 }, { "number": 5, "title": "Colchicine as First-Choice Therapy for Recurrent Pericarditis: Results of the CORE (COlchicine for REcurrent pericarditis) Trial | Cardiology | JAMA Internal Medicine | JAMA Network", "detail": "jamanetwork.com", "url": "https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/486705", "authors": "jamanetwork.com", "host": "jamanetwork.com", "snippet": "Colchicine as First-Choice Therapy for Recurrent Pericarditis: Results of the CORE (COlchicine for REcurrent pericarditis) Trial | Cardiology | JAMA Internal Medicine | JAMA Network(#skip-to-navigation)\n\nJAMA Cardiology Sign up for updates", "score": 0.33189937 }, { "number": 6, "title": "Pericarditis - The Lancet", "detail": "www.thelancet.com", "url": "https://www.thelancet.com/journals/lancet/article/PIIS0140673604156481/abstract", "authors": "www.thelancet.com", "host": "www.thelancet.com", "snippet": "pericarditis is most commonly idiopathic, and radiation therapy, cardiac surgery, and percutaneous procedures have become important causes. Pericarditis", "score": 0.3991562 }, { "number": 7, "title": "A single-cell and spatial transcriptomic atlas of human tuberculous ...", "detail": "www.thelancet.com", "url": "https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(26)00115-5/fulltext", "authors": "www.thelancet.com", "host": "www.thelancet.com", "snippet": "Tuberculous constrictive pericarditis (TB-CP) is a severe complication of Mycobacterium tuberculosis infection that causes diastolic heart failure", "score": 0.28062916 }, { "number": 8, "title": "Constrictive pericarditis after high-dose chemotherapy - The Lancet", "detail": "www.thelancet.com", "url": "https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)64017-2/fulltext", "authors": "www.thelancet.com", "host": "www.thelancet.com", "snippet": "The cause of this constrictive pericarditis was not established but it may be associated with high-dose chemotherapy. The CTC regimen is the most frequently", "score": 0.21241207 }, { "number": 9, "title": "Effusive Constrictive Pericarditis in the Era of COVID-19", "detail": "www.acpjournals.org", "url": "https://www.acpjournals.org/doi/10.7326/aimcc.2023.1360", "authors": "www.acpjournals.org", "host": "www.acpjournals.org", "snippet": "Effusive-constrictive pericarditis is a rare condition in which the visceral pericardium compresses the heart, with fluid accumulation in", "score": 0.38796914 }, { "number": 10, "title": "Pericardial Diseases: International Position Statement on New Concepts and Advances in Multimodality Cardiac Imaging", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S1936878X24001608", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Pericardial diseases have gained renewed clinical interest, leading to a renaissance in the field. There have been many recent advances in pericardial diseases in both multimodality cardiac imaging of diagnoses, such as recurrent, transient constrictive and effusive-constrictive pericarditis, and ta", "score": 0.6180666 }, { "number": 11, "title": "Recurrent pericarditis in children: Clinical and therapeutic differences from adults", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/abs/pii/S0167527326004067", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "According the 2025 European Society of Cardiology (ESC) guidelines the definite clinical diagnosis of pericarditis requires compatible clinical presentation (chest pain and/or dyspnea) and more than one additional criterion: pericardial rubs; PR depression and/or widespread ST-segment elevation at ", "score": 0.5712171 }, { "number": 12, "title": "Management of Acute and Recurrent Pericarditis: JACC State-of-the ...", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/science/article/pii/S0735109719384840", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Pericarditis refers to the inflammation of the pericardial layers, resulting from a variety of stimuli triggering a stereotyped immune response, and characterized by chest pain associated often with peculiar electrocardiographic changes and, at times, accompanied by pericardial effusion. Acute peric", "score": 0.54985875 }, { "number": 13, "title": "Acute Pericarditis - an overview | ScienceDirect Topics", "detail": "www.sciencedirect.com", "url": "https://www.sciencedirect.com/topics/neuroscience/acute-pericarditis", "authors": "www.sciencedirect.com", "host": "www.sciencedirect.com", "snippet": "Cumulative anecdotal data, expert consensus, and an open-label clinical trial5 suggest that addition of colchicine at 1 mg/day for 3 months, with or without a 2-mg loading dose, is effective for the acute episode, is well tolerated, and may prevent recurrences. Accordingly, it has been given a class", "score": 0.54564947 }, { "number": 14, "title": "Constrictive Pericarditis as a Rare Manifestation of Graft‐Versus ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1002/ccr3.70479", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "Although cardiac CT and MRI are helpful in diagnosing CP, the patient's severe elbow contractures and the clear echocardiographic findings made", "score": 0.54535896 }, { "number": 15, "title": "Recurrent pericarditis in older adults: Clinical and laboratory ...", "detail": "agsjournals.onlinelibrary.wiley.com", "url": "https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.19150", "authors": "agsjournals.onlinelibrary.wiley.com", "host": "agsjournals.onlinelibrary.wiley.com", "snippet": "At present, the diagnostic criteria for pericarditis, codified by the 2015 European Society of Cardiology (ESC) guidelines, refer to the", "score": 0.5185224 }, { "number": 16, "title": "Myopericarditis and Pericardial Effusion as the Initial Presentation of ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1155/2017/6912020", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "Cardiac MRI has been shown to be a very useful imaging modality in confirming the diagnosis of myocarditis. According to the International", "score": 0.4116553 }, { "number": 17, "title": "Pharmacotherapy Update of Acute Idiopathic Pericarditis", "detail": "accpjournals.onlinelibrary.wiley.com", "url": "https://accpjournals.onlinelibrary.wiley.com/doi/10.1002/phar.1527", "authors": "accpjournals.onlinelibrary.wiley.com", "host": "accpjournals.onlinelibrary.wiley.com", "snippet": "The most sensitive method for the diagnosis of acute pericarditis is delayed enhancement of the pericardium on CMR. In cases where the diagnosis", "score": 0.35736617 }, { "number": 18, "title": "Recent advances in multimodality imaging‐guided therapy in ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/10.1111/eci.70067", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "In the era of precision medicine, cardiac multimodality imaging plays a vital role in diagnosing, managing, and monitoring pericarditis. This", "score": 0.34554735 }, { "number": 19, "title": "The right heart in patients with cancer. A scientific ...", "detail": "onlinelibrary.wiley.com", "url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ejhf.3412", "authors": "onlinelibrary.wiley.com", "host": "onlinelibrary.wiley.com", "snippet": "by K Keramida · 2024 · Cited by 25 — Confirm PH diagnosis. Constrictive pericarditis. Complex congenital heart diseases. AL, light chain; CMR, cardiac magnetic resonance; ECG, electrocardiogram ...Read more", "score": 0.304828 }, { "number": 20, "title": "[PDF] MYocarditis and/or pericarditis following mRNA COVID-19 ...", "detail": "cdn.clinicaltrials.gov", "url": "https://cdn.clinicaltrials.gov/large-docs/23/NCT06103123/Prot_000.pdf", "authors": "cdn.clinicaltrials.gov", "host": "cdn.clinicaltrials.gov", "snippet": "or endomyocardial biopsy) showed myocardial inflammation. b. Elevated myocardial biomarker (Troponin T, Troponin I, or CK-MB). c. Cardiac MRI abnormality. d. Echocardiographic abnormality. e. New or worsening arrhythmia on electrocardiogram, Holter monitor, or telemetry. f. Elevated inflammation bio", "score": 0.44912744 }, { "number": 21, "title": "Journal of the American Society of Echocardiography", "detail": "www.jtcvs.org", "url": "https://www.jtcvs.org/article/S0894-7317(13)00533-6/fulltext", "authors": "www.jtcvs.org", "host": "www.jtcvs.org", "snippet": "Recurrent pericarditis can generally be treated with a prolonged course of NSAIDs. Colchicine can be added to NSAIDs or as monotherapy.", "score": 0.65966886 }, { "number": 22, "title": "Diagnostic issues in the clinical management of pericarditis - PubMed", "detail": "www.ncbi.nlm.nih.gov", "url": "https://www.ncbi.nlm.nih.gov/pubmed/20487049", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "Results: The diagnosis of pericarditis is based on clinical criteria including symptoms, presence of specific physical findings (rubs), electrocardiographical changes and pericardial effusion. Although the aetiology may be varied, most cases are idiopathic or viral, even after an extensive diagnosti", "score": 0.6002124 }, { "number": 23, "title": "Secondary pericarditis: from a suspect to the management", "detail": "www.escardio.org", "url": "https://www.escardio.org/Councils/Council-for-Cardiology-Practice-(CCP)/Cardiopractice/secondary-pericarditis-from-a-suspect-to-the-management", "authors": "www.escardio.org", "host": "www.escardio.org", "snippet": "#### What are the causes of pericarditis?\n\nWhile pericarditis is idiopathic in almost 90% of cases and is generally due to viral infections, secondary pericarditis may be: 1) infective, and especially related to tuberculosis (TB); 2) associated with immune diseases such systemic lupus erythematosus ", "score": 0.4719782 }, { "number": 24, "title": "Drug-Induced Lupus Erythematosus - StatPearls - NCBI Bookshelf", "detail": "www.ncbi.nlm.nih.gov", "url": "http://www.ncbi.nlm.nih.gov/books/NBK441889", "authors": "www.ncbi.nlm.nih.gov", "host": "www.ncbi.nlm.nih.gov", "snippet": "## Evaluation\n\nThe diagnostic evaluation of DIL largely parallels that of idiopathic SLE, but with a heightened focus on drug history and the temporal relationship between exposure and symptom onset. Symptoms often appear after months or years of continuous therapy. A detailed clinical assessment sh", "score": 0.39789218 } ], "publishedAt": "2026-09-15T22:54:27.838597+00:00", "updatedAt": "2026-09-15T22:54:27.838597+00:00", "readingMinutes": 7, "slug": "pericarditis" }