[Acute pericarditis--clinical quality control trial]

Quality control aims to analyze not only the results of therapy but the efficiency and cost effectiveness of diagnostic procedures. In a catamnestic analysis of the outcome in 97 patients with acute pericarditis seen at this hospital from 1982 to 1992, we tried to answer the question whether a conservative diagnostic strategy might harm the patient. The outcome in 33 patients after limited diagnostic activity (patient story, clinical status; WBC differential count, ESR; creatinine and creatine kinase; ECG and chest x-ray) was the same as in 33 patients who underwent additional diagnostic procedures. Moreover, in patients in whom after limited diagnostic activity the etiology of acute pericarditis (precordial pain and friction rub) remained unclear, additional diagnostic procedures did not settle the problem. We conclude that extensive and even invasive diagnostic procedures are justified in selected patients and in special circumstances only (fever > 38 degrees and protracted course of disease, marked pericardial effusion or threatening tamponade; epidemiological or scientific interest).