Acute Pericarditis

Dr Swapnil Pawar July 19, 2021 6647 5

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Blog written by – Dr Andrew Lam

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    Acute Pericarditis
    Dr Swapnil Pawar

High-Risk Features that May Require Admission:

Fever > 38°C
The sub-Acute course of symptoms, progressing over several days to weeks
Evidence of cardiac tamponade
Moderate to large pericardial effusion
Failure to improve despite initial medical therapy with NSAID’s and colchicine
Elevated troponin (suggestive of perimyocarditis)

ECG Findings in Acute Pericarditis                                                                                       

Acute Pericarditis – Widespread concave ST elevation (V2-6) and (I, II, aVL, aVF)

Aetiology of Pericarditis

Indeterminate: Assumed to be of viral or immune origin
Viral – Coxsackie, echovirus, adenovirus, EBV, CMV, influenza, HIV
Bacterial – M. Tuberculosis, Staphylococcus, Streptococcus, Haemophilus, Salmonella, Chlamydia
Fungal – Histoplasmosis, Aspergillus
Parasitic – Echinococcus, Toxoplasma, Amoebic
Malignant: Metastatic breast or lung cancer, melanoma, leukemia, lymphoma.
Cardiac: Post-infarction, Dressler’s syndrome
Metabolic: Uraemia
Drug-Induced (rare): Isoniazid, hydralazine, anticoagulants, thrombolytics, phenytoin, penicillins


Burns, E., Buttner, R. (2021). Pericarditis. Life in the Fastlane. Retrieved 5th July 2021 from

Hoit, B.D. (2021) Etiology of pericardial disease. UpToDate. Retrieved 5th July 2021 from

Imazio, M. (2021) Acute pericarditis: Clinical presentation, diagnostic evaluation and diagnosis. UpToDate. Retrieved 5th July 2021 from

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