[Diagnostics and therapy of pericarditis and pericardial effusion]

Area of Science:

• Cardiology
• Internal Medicine
• Diagnostic Imaging

Context:

• Pericardial diseases, including pericarditis, effusion, and tamponade, require precise etiological diagnosis for effective management.
• Current diagnostic and therapeutic strategies are guided by European Society of Cardiology (ESC) guidelines.
• Echocardiography is a key initial diagnostic tool for symptomatic patients with pericardial effusion.

Purpose:

• To provide a comprehensive overview of the diagnostics, differential diagnostics, and therapeutic approaches for acute and chronic pericarditis, constrictive pericarditis, pericardial effusion, and cardiac tamponade.
• To emphasize the importance of etiological allocation in guiding clinical presentation, disease course, therapy, and prognosis.
• To discuss the role of multimodal imaging, invasive diagnostic therapy, and specific treatments based on etiology.

Summary:

• Diagnostic strategies involve differentiating infectious, autoreactive, and neoplastic causes through effusion cytology, biopsies (immunohistological, molecular), and pericardioscopy.
• Therapeutic interventions include intrapericardial administration of cisplatin for neoplastic effusions and triamcinolone for autoreactive pericarditis.
• Long-term colchicine treatment is also presented as a therapeutic option.

Impact:

• Accurate etiological diagnosis significantly influences the clinical picture, therapeutic decisions, and patient prognosis in pericardial diseases.
• Specific therapeutic interventions, such as intrapericardial agents and colchicine, can effectively prevent recurrence and manage pericardial conditions.
• This comprehensive approach ensures optimal patient management based on established guidelines and etiological factors.