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Pericarditis

Veronica J. Ruston, DO Reviewed 06/2020
 


BASICS

DESCRIPTION

Inflammation of the pericardium, with or without associated pericardial effusion. Myopericarditis or perimyocarditis refers to cases that have myocardial involvement in addition to i...

DIAGNOSIS

  • Diagnostic clinical criteria

    • Acute pericarditis (at least two of four criteria)

      • Typical (pleuritic) chest pain

      • Pericardial friction rub (<33% of cases)

      • ECG changes with widespread (non-region...

TREATMENT

  • Goal of treatment is to relieve pain and reduce complications (e.g., recurrence, tamponade, chronic constrictive pericarditis).

  • Outpatient therapy is reported to be successful in 85% patients...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • 7 to 10 days to assess response to treatment

  • 1 month to check CBC and CRP and thereafter if symptoms continue to be present

  • Those with clinical predictors of poor p...

REFERENCES

1
Imazio M, Brucato A, Belli R, et al. Colchicine for the prevention of pericarditis: what we know and what we do not know in 2014—systematic review and meta-analysis. J Cardiovasc Med (Hage...

ADDITIONAL READING

  • Brucato A, Imazio M, Gattorno M, et al. Effect of anakinra on recurrent pericarditis among patients with colchicine resistance and corticosteroid dependence: the AIRTRIP randomized ...

CODES

ICD10

  • I31.9 Disease of pericardium, unspecified

  • I30.9 Acute pericarditis, unspecified

  • I30.1 Infective pericarditis

  • I31.1 Chronic constrictive pericarditis

  • I31.0 Chronic adhesive pericarditis

ICD9

  • 423.9...

CLINICAL PEARLS

  • Therapy aimed at symptomatic relief and NSAIDs are first-line treatment. Colchicine is recommended as an adjunct to NSAIDs and has been shown to decrease risk of recurrence by 50%.

  • Peri...

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