Pericardial disease: diagnosis and management.
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.
Khandaker
Masud H
MH
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
Espinosa
Raul E
RE
Nishimura
Rick A
RA
Sinak
Lawrence J
LJ
Hayes
Sharonne N
SN
Melduni
Rowlens M
RM
Oh
Jae K
JK
D002305:Cardiac Tamponade / Q000175:diagnosis / Q000628:therapy; D006331:Heart Diseases / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D010490:Pericardial Effusion / Q000628:therapy; D010493:Pericarditis / Q000175:diagnosis / Q000188:drug therapy; D010494:Pericarditis, Constrictive / Q000175:diagnosis; D010496:Pericardium / Q000002:abnormalities