🫀 Acute Pericarditis Diagnosis (ESC 2015)
ESC 2015 clinical criteria diagnose acute pericarditis and flag high-risk features warranting admission.
Acute Pericarditis Diagnosis (ESC 2015)
Pericarditic chest pain (sharp/pleuritic, relieved by sitting forward)
Pericardial friction rub
ECG: new widespread ST elevation or PR depression
New/worsening pericardial effusion
High-risk features (fever > 38℃/subacute onset/large effusion/tamponade/no response to NSAID after 1 week; or myocardial involvement/immunosuppression/trauma/oral anticoagulation)
When to use
Use to apply the ≥ 2/4 criteria, identify high-risk features, and direct anti-inflammatory therapy and disposition.
How it works
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.
Key points
- 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.
References
- Adler Y, et al. 2015 ESC pericardial diseases guideline. Eur Heart J 2015.
- Imazio M, et al. ICAP trial (colchicine). N Engl J Med 2013.
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.