Pericarditis is a common disorder that has multiple causes and presents in various primary-care and secondary-care settings. New diagnostic techniques have improved the sampling and analysis of pericardial fluid and allow comprehensive characterisation of cause. Despite this advance, pericarditis is most commonly idiopathic, and radiation therapy, cardiac surgery, and percutaneous procedures have become important causes. Pericarditis is frequently self-limiting, and non-steroidal anti-inflammatory agents remain the first-line treatment for uncomplicated cases. Integrated use of new imaging methods facilitates accurate detection and management of complications such as pericardial effusion or constriction. Differentiation of constrictive pericarditis from restrictive cardiomyopathy remains a clinical challenge but is facilitated by tissue doppler and colour M-mode echocardiography. Most pericardial effusions can be safely managed with an echo-guided percutaneous approach. Pericardiectomy remains the definitive treatment for constrictive pericarditis and provides symptomatic relief in most cases. In the future, the pericardial space might become a conduit for treatments directed at the pericardium and myocardium.
AuthorsRichard W Troughton, Craig R Asher, Allan L Klein
JournalLancet (London, England) (Lancet) Vol. 363 Issue 9410 Pg. 717-27 (Feb 28 2004) ISSN: 1474-547X [Electronic] England
PMID15001332 (Publication Type: Journal Article, Review)
Chemical References
  • Anti-Bacterial Agents
  • Acute Disease
  • Anti-Bacterial Agents (therapeutic use)
  • Cardiac Surgical Procedures
  • Humans
  • Pericardial Effusion (diagnosis, epidemiology, surgery)
  • Pericardiectomy
  • Pericarditis (diagnosis, epidemiology, therapy)
  • Pericardium (physiology)

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