Pathogenesis, diagnosis and treatment of pericarditis

  • Bernhard Maisch
  • Konstantinos Karatolios
  • Sabine Pankuweit
  • Arsen Ristic
Part of the Progress in Inflammation Research book series (PIR)


The spectrum of inflammatory pericardial syndromes includes acute, chronic and recurrent (relapsing) pericarditis, pericardial effusion and cardiac tamponade as well as constrictive pericarditis. The etiology of pericardial diseases is extensive, including infectious, non-infectious, systemic and autoimmune causes. A substantial proportion of idiopathic pericarditis represents viral infections or autoreactive pericarditis. The diagnosis of pericardial diseases is based on clinical presentation, electrocardiogram changes and echocardiographic findings. Pericardiocentesis, pericardioscopy with pericardial biopsy and contemporary pathology, immunohistochemistry and molecular biology techniques have extended the diagnostic armamentarium and contributed to etiopathogenetic understanding and treatment in pericardial diseases. Nevertheless, in uncomplicated cases, resolving to conventional anti-inflammatory treatment such a comprehensive approach is clinically not justified. On the other side, in chronic, recurrent or resistant forms an etiological diagnosis enables specific treatment. Furthermore, intrapericardial treatment after pericardiocentesis with cytostatic agents (cisplatin or thiotepa) in malignant pericardial effusions or sclerosing agents (triamcinolone, gentamycin) in chronic recurrent autoreactive effusions may prevent recurrences. Pericardiocentesis is life saving in cardiac tamponade and indicated in large effusions (> 20 mm in echocardiography in diastole), and suspected purulent, tuberculous and neoplastic pericarditis. Pericardiectomy is the only treatment for permanent constriction.


Familial Mediterranean Fever Pericardial Effusion Cardiac Tamponade Constrictive Pericarditis Pericardial Fluid 
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Copyright information

© Springer Basel 2010

Authors and Affiliations

  • Bernhard Maisch
    • 1
  • Konstantinos Karatolios
    • 1
  • Sabine Pankuweit
    • 1
  • Arsen Ristic
  1. 1.Department of Internal Medicine — CardiologyUniversity Hospital of Giessen and Marburg, Philipps-Universität MarburgMarburgGermany

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