Acute Pericarditis

Abstract

The entire breadth of acute pericardial illness encompasses a diverse and long list of etiologies.^1–3 Clinicians deal with the types of pericardial disease most likely to present to their specialty and practice setting. Cancer specialists are most frequently exposed to malignant pericardial disease, thoracic surgeons are experienced in the management of traumatic and postoperative pericardial disease, and nephrologists commonly treat uremic or dialysis-associated pericarditis. Tertiary care centers may be involved in the evaluation or treatment of the more acute pericardial illnesses (i.e. tamponade) as well as the coordination of long-term care of chronic pericardial disorders. What is the role of the general internist? This case report and the following discussion will focus upon primary acute idiopathic pericarditis (no obvious cause on initial presentation), in which the general internist is more likely to be initially involved. The goals for this chapter are to (1) discuss the presenting features of acute idiopathic pericarditis, (2) establish a differential diagnosis, (3) recommend a reasonable diagnostic approach in reference to the extensive list of causes, and (4) suggest guidelines for therapy and follow up.