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Complete Diagnostic Approach to Acute Pericarditis

Click on boxes to expand/collapse detailed information.


 
 
 
 
 
 
 

Characterize the symptoms



 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Obtain a detailed history



 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Examine the patient

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Order tests (Urgent)

❑ Laboratory tests
❑ ECG
❑ Chest X-ray
❑ Echocardiography
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Does the patient have at least two of the following criteria for the diagnosis of acute pericarditis?

❑ Characteristic chest pain
❑ Pericardial friction rub
❑ Suggestive ECG changes
❑ Suggestive echocardiography changes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Yes

 
 
 
 
 
 
 
 
 

No

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Does the patient have any sign of myocarditis?

 
 
 
 
 
 
 
 
 

Does the patient have any signs suspicious of acute pericarditis?

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

No

 
 
 
 

Yes

 
 

No

 
 
 
 

Yes

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Acute pericarditis

 
 
 

Myopericarditis

 
 
 

Consider alternative diagnosis and treat accordingly

 
 
 

Consider cardiac MRI (CMR)[1]

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Treat as acute pericarditis or myopericarditis if there is delayed enhancement on CMR

 
 
  1. Khandaker MH, Espinosa RE, Nishimura RA; et al. (2010). "Pericardial disease: diagnosis and management". Mayo Clinic Proceedings. Mayo Clinic. 85 (6): 572–93. doi:10.4065/mcp.2010.0046. PMC 2878263. PMID 20511488. Unknown parameter |month= ignored (help)