Pericardial diseases can present clinically as acute pericarditis, pericardial effusion,
cardiac tamponade, and constrictive pericarditis. Patients can subsequently develop
chronic or recurrent pericarditis. Structural abnormalities including congenitally
absent pericardium and pericardial cysts are usually asymptomatic and are uncommon.
Clinicians are often faced with several diagnostic and management questions relating
to the various pericardial syndromes: What are the diagnostic criteria for the vast
array of pericardial diseases? Which diagnostic tools should be used? Who requires
hospitalization and who can be treated as an outpatient? Which medical management
strategies have the best evidence base? When should corticosteroids be used? When
should surgical pericardiectomy be considered? To identify relevant literature, we
searched PubMed and MEDLINE using the keywords diagnosis, treatment, management, acute pericarditis, relapsing or recurrent pericarditis, pericardial effusion, cardiac tamponade, constrictive pericarditis, and restrictive cardiomyopathy. Studies were selected on the basis of clinical relevance and the impact on clinical
practice. This review represents the currently available evidence and the experiences
from the pericardial clinic at our institution to help guide the clinician in answering
difficult diagnostic and management questions on pericardial diseases.
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Article Info
Footnotes
On completion of this article, you should be able to: (1) identify the diagnostic criteria for acute and relapsing pericarditis, cardiac tamponade, and constrictive pericarditis; (2) integrate the information obtained from a history, physical examination, electrocardiography, and laboratory studies to determine if further imaging modalities or invasive cardiac catheterization is necessary for the diagnosis of the various pericardial syndromes; and (3) apply management strategies on the basis of evidence and clinical experience to decrease morbidity and improve survival in patients with pericardial disease.
Identification
Copyright
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