Pericarditis differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Pericarditis differential diagnosis

Many other conditions produce signs and symptoms similar to those produced by pericarditis. Keep in mind that pericarditis might also be one of the following: "part of a generalized disease", "apparently isolated", or "part of a disease that affects a nearby organ", and "sometimes is the presenting syndrome of multiple diseases."

Key Signs & Symptoms to Differentiate Pericarditis:

1. Pain on the trapezius ridge(s), is a pathognomonic of pericarditis. Often pain can radiate mimicking pain that is commonly felt during angina.
2. Central pleuritic chest pain (can also be indicative of pleurisy; however, may be both)
3. Pain that lasts longer, is sharper and unresponsive to vasodilator therapy (similar "to that of cardiac ischemia")
4. Most acute pericarditis ECGs are similar to ECGs of ischemic heart disease rather than infarction
5. Pulmonary embolism can present similarly to pericarditis, but can be differentiated from pericarditis in the presence of one of the following findings: a nonspecifically altered ECG, a plerual rub, and non-precordial (someitmes precordial pain is present regardless).

Differential Diagnosis of Causes of Acute Pericarditis

• Actinomycosis
• Acute idiopathic pericarditis
• Acute rheumatic fever
• Adenovirus
• Addison's crisis
• Amyloidosis
• Amebiasis
• Ankylosing Spondylitis
• Aortic dissection
• Behcet's Disease
• Borrelia
• Breast cancer
• Chylopericardium
• Coxsackie A
• Coxsackie B
• Cytomegalovirus
• Dermatomyositis
• Dermatosclerosis
• Dressler's Syndrome
• EBV
• ECHO virus
• Echinococcosis
• Familial Mediterranian Fever
• Francisella
• HIV
• Infectious mononucleosis
• Inflammatory Bowel Disease
• Influenza virus
• Legionella
• Leukemia
• Lung cancer
• Lymphoma
• Meningococci
• Mixed Connective Tissue Disease
• Mumps virus
• Mycoplasma infection
• Neisseria gonorrhoeae
• Perforated esophagus
• Pneumococci
• Polyarteritis Nodosa
• Polymyositis
• Postpericardiotomy syndrome
• Reiter's Syndrome
• Radiation therapy
• Renal Failure
• Rheumatoid Arthritis
• Rickettsia
• Sarcoidosis
• Scleroderma
• Serum sickness
• Staphylococci
• Streptococci
• Systemic Lupus Erythematosus
• Thorax trauma
• Treponema pallidum
• Toxoplasmosis
• Tuberculosis
• Uremia
• Varicella virus
• Wegener's granulomatosis
• Whipple's Disease

Differential Diagnosis of Causes of Chronic Pericarditis

• Amebiasis
• Bacterial infections
• Cholesterol pericarditis
• Chylopericardium
• Coccidioidomycosis
• Collagen Vascular Disease
• Coxsackie B
• Echinococcosis
• Histoplasmosis
• Neoplastic pericarditis
• Tuberculosis
• Uremic pericarditis