Investigating Pericarditis Diagnosis in a Tertiary Pericardial Center: A Descriptive Study

Area of Science:

• Cardiology
• Diagnostic Medicine

Background:

• Pericarditis diagnosis is often challenging due to nonspecific symptoms, leading to frequent misdiagnosis.
• Accurate diagnosis is crucial for effective patient management and outcomes.

Purpose of the Study:

• To determine the prevalence of misdiagnosed pericarditis.
• To identify characteristics differentiating accurately diagnosed from misdiagnosed patients.

Main Methods:

• A prospective registry of 170 patients referred to a Pericardial Center was analyzed.
• Data included demographics, comorbidities, symptoms, labs, and imaging, compared between correctly diagnosed and misdiagnosed groups.
• Diagnosis was confirmed using 2015 European Society of Cardiology guidelines.

Main Results:

• Thirty-five percent of patients were misdiagnosed with pericarditis.
• Misdiagnosed patients had lower rates of coronary artery disease, valvular disease, and atrial fibrillation compared to accurately diagnosed patients.
• Accurate diagnosis was associated with specific pericardial pain, ECG changes, elevated inflammatory markers, and late gadolinium enhancement on MRI. COVID-19 infection was more prevalent in the misdiagnosed group.

Conclusions:

• A significant proportion (35%) of pericarditis diagnoses are inaccurate.
• Inflammatory markers and MRI findings like late gadolinium enhancement are valuable diagnostic aids.
• COVID-19 infection is linked to an increased risk of misdiagnosing pericarditis.