title: Diagnostic yield of extensive infectious panel testing in acute pericarditis.
abstract: OBJECTIVE
  In an attempt to reconsider our local strategy, we evaluated patients with viral/idiopathic pericarditis in order to assess the diagnostic yield of our standard infectious panel, the characteristics of myocardial involvement, the utility of investigating myocardial involvement and the incidence of coronary evaluation tests.
  
  
  METHODS
  Seventy-six consecutive cases of idiopathic/viral acute pericarditis treated between March 2005 and March 2008 were retrospectively enrolled. Telephonic questionnaires were answered by all.
  
  
  RESULTS
  Myopericarditis was recorded in 45/71 (63.4%) consecutive patients. Sore throat on presentation (38 vs. 12%; p = 0.027) was the only symptom independently associated with myopericarditis. The following clinical features were significantly correlated with pericarditis rather than myopericarditis: age (42 ± 16 vs. 32 ± 12; p = 0.008), C-reactive protein (131 ± 75 vs. 78 ± 58; p = 0.009) and lower CPK and troponin levels (mean 96 vs. mean 489; p < 0.001 and mean 0 vs. mean 10; p < 0.001, respectively). The infectious panel revealed 6 positive results. After an average 3 years' fol- low-up, recurrence was documented in 5 patients (7%). No patient initially regarded idiopathic developed systemic disease during follow-up.
  
  
  CONCLUSIONS
  Among patients presenting with presumed idiopathic/viral pericarditis, myopericarditis is relatively common and has a benign evolution. Extensive serological investigation with a broad infectious panel proved to be diagnostically and therapeutically futile in our area.
authors.affiliation: Cardiology Department, Tel Aviv Medical Center, Tel Aviv, Israel. ramia@hadassah.org.il
authors.forename: Rami
authors.initials: R
authors.lastname: Abu Fanne
authors.forename: Shmuel
authors.initials: S
authors.lastname: Banai
authors.forename: Udi
authors.initials: U
authors.lastname: Chorin
authors.forename: Ori
authors.initials: O
authors.lastname: Rogowski
authors.forename: Gad
authors.initials: G
authors.lastname: Keren
authors.forename: Arie
authors.initials: A
authors.lastname: Roth
mesh_terms: D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001774:Blood Chemical Analysis; D002097:C-Reactive Protein / Q000032:analysis; D015331:Cohort Studies; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D017053:Infection Control; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology*; D010493:Pericarditis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000821:virology*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D019210:Troponin I / Q000032:analysis; D014505:Urban Population; D014777:Virus Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D054328:Proton Pump Inhibitors; D019210:Troponin I; D002097:C-Reactive Protein