Acute Pericarditis Diagnosis (ESC 2015) — free guideline decision tool
ESC 2015 clinical criteria diagnose acute pericarditis and flag high-risk features warranting admission.
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Implements the decision logic from published clinical guidelines.
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Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Pericarditic chest pain (sharp/pleuritic, relieved by sitting forward) | No |
|---|---|
| Pericardial friction rub | No |
| ECG: new widespread ST elevation or PR depression | No |
| New/worsening pericardial effusion | No |
| High-risk features (fever > 38℃/subacute onset/large effusion/tamponade/no response to NSAID after 1 week; or myocardial involvement/immunosuppression/trauma/oral anticoagulation) | None |
→Acute pericarditisCriteria not met (0/4)
- Criteria count：0/4 (chest pain/rub/ECG/effusion) → < 2, clinical diagnosis not met
- Supporting tests：Elevated inflammatory markers (CRP/ESR/WBC), CT/CMR showing pericardial inflammation support the diagnosis; recommended initial four: ECG, transthoracic echo, chest X-ray, inflammatory markers + troponin (to assess myocardial involvement)
- Risk stratification：No high-risk features → most can be managed as outpatients with empiric anti-inflammatory therapy and follow-up
| Pericarditic chest pain (sharp/pleuritic, relieved by sitting forward) | Yes |
|---|---|
| Pericardial friction rub | Yes |
| ECG: new widespread ST elevation or PR depression | Yes |
| New/worsening pericardial effusion | Yes |
| High-risk features (fever > 38℃/subacute onset/large effusion/tamponade/no response to NSAID after 1 week; or myocardial involvement/immunosuppression/trauma/oral anticoagulation) | Any present |
→Acute pericarditisDiagnosis met (≥ 2/4)
- Criteria count：4/4 (chest pain/rub/ECG/effusion) → ≥ 2, diagnosis met
- Supporting tests：Elevated inflammatory markers (CRP/ESR/WBC), CT/CMR showing pericardial inflammation support the diagnosis; recommended initial four: ECG, transthoracic echo, chest X-ray, inflammatory markers + troponin (to assess myocardial involvement)
- Risk stratification：High-risk features present → recommend admission, investigate etiology (beware bacterial/neoplastic/systemic disease)
Common questions
What is Acute Pericarditis Diagnosis (ESC 2015)?
ESC 2015 clinical criteria diagnose acute pericarditis and flag high-risk features warranting admission.
How is Acute Pericarditis Diagnosis (ESC 2015) calculated? What is the core formula?
Diagnosis with ≥ 2 of: pericarditic chest pain, friction rub, ECG (widespread ST elevation/PR depression), pericardial effusion. High-risk features (fever > 38℃, large effusion, tamponade, NSAID failure, etc.) favor admission. Treatment: ASA/NSAID + colchicine.
When is Acute Pericarditis Diagnosis (ESC 2015) used?
Use to apply the ≥ 2/4 criteria, identify high-risk features, and direct anti-inflammatory therapy and disposition.
What are the key clinical points for Acute Pericarditis Diagnosis (ESC 2015)?
Colchicine added to ASA/NSAID reduces recurrence and is part of standard first-line therapy (original synthesis · not guideline verbatim). Corticosteroids are avoided first-line in idiopathic/viral pericarditis because they increase recurrence. Troponin should be checked to detect myopericardial involvement, which changes risk and management.
What are the limits and cautions when using Acute Pericarditis Diagnosis (ESC 2015)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Acute Pericarditis Diagnosis (ESC 2015) calculated in practice? Can you show a worked example?
Inputs: Pericarditic chest pain (sharp/pleuritic, relieved by sitting forward) No, Pericardial friction rub No, ECG: new widespread ST elevation or PR depression No, New/worsening pericardial effusion No, High-risk features (fever > 38℃/subacute onset/large effusion/tamponade/no response to NSAID after 1 week; or myocardial involvement/immunosuppression/trauma/oral anticoagulation) None → Result: Acute pericarditis Criteria not met (0/4)（Criteria count: 0/4 (chest pain/rub/ECG/effusion) → < 2, clinical diagnosis not met, Supporting tests: Elevated inflammatory markers (CRP/ESR/WBC), CT/CMR showing pericardial inflammation support the diagnosis; recommended initial four: ECG, transthoracic echo, chest X-ray, inflammatory markers + troponin (to assess myocardial involvement), Risk stratification: No high-risk features → most can be managed as outpatients with empiric anti-inflammatory therapy and follow-up） Inputs: Pericarditic chest pain (sharp/pleuritic, relieved by sitting forward) Yes, Pericardial friction rub Yes, ECG: new widespread ST elevation or PR depression Yes, New/worsening pericardial effusion Yes, High-risk features (fever > 38℃/subacute onset/large effusion/tamponade/no response to NSAID after 1 week; or myocardial involvement/immunosuppression/trauma/oral anticoagulation) Any present → Result: Acute pericarditis Diagnosis met (≥ 2/4)（Criteria count: 4/4 (chest pain/rub/ECG/effusion) → ≥ 2, diagnosis met, Supporting tests: Elevated inflammatory markers (CRP/ESR/WBC), CT/CMR showing pericardial inflammation support the diagnosis; recommended initial four: ECG, transthoracic echo, chest X-ray, inflammatory markers + troponin (to assess myocardial involvement), Risk stratification: High-risk features present → recommend admission, investigate etiology (beware bacterial/neoplastic/systemic disease)）
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ESC 2015 clinical criteria diagnose acute pericarditis and flag high-risk features warranting admission.
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