Pericarditis differential diagnosis

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

Differentiating Pericarditis from other Conditions

Several conditions, including life threatening conditions such as myocardial infarction, aortic dissection and pulmonary embolism produce signs and symptoms that are similar to those produced by pericarditis.

• Pain along the trapezius ridge(s), is pathognomonic of pericarditis.
• Unlike cardiac ischemia, the pain of pericarditis often lasts longer, is sharper and unresponsive to vasodilator therapy
• The EKG of pericarditis shows PR segment depression while the EKG of myocardial infarction does not.
• The EKG of pericarditis shows ST elevation that does not necessarily follow the anatomic distribution of a single coronary artery

Keep in mind that pericarditis might also be one of the following: part of a generalized disease, an isolated disease, part of a disease that affects a nearby organ, and sometimes is the presenting syndrome of multiple diseases.

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