[Daily management of acute pericarditis: clinical and paraclinical outcomes, etiological diagnosis]

Ann Cardiol Angeiol (Paris). 2008 Feb;57(1):1-9. doi: 10.1016/j.ancard.2008.01.003. Epub 2008 Feb 1.
[Article in French]

Abstract

Introduction: Acute pericarditis is a frequent hospitalization cause. A prospective, bicentric study aimed at different goals: population description, aetiologies screening, and evaluation of the interest of a coordinated and combined management between cardiologists and internists.

Patients and methods: Between May 2005 and September 2007, all patients admitted for acute pericarditis were prospectively enrolled. Physical examination, ECG, echocardiography, biological screening were performed. Patients were asked to consult both cardiologist and internist, one month later.

Results: Hundred and three patients were enrolled (mean age 43 years). Clinical outcome was classical in 60% of cases. ECG was typical in 59%. Troponin elevation was noted in 30% of patients. CRP was normal at diagnosis in 27% of patients, and increased significantly at first day (P=0.002). Possible cause was identified in 44 patients. In 26 patients (24.3%), precise diagnosis was performed: six cancers, one hemopathy, three connectivities, one EBV and one parvovirus B19 seroconversions, two untreated HIV patients, four inflammatory diseases, three endocrinology troubles, one oesophagitis, one dental sepsis, one amyloidosis, one acute pancreatitis, one declined dialysis indication. Eighteen de novo diagnoses (16.5%) were performed, out of them at least 12 benefited from specific management.

Conclusion: Population of patients admitted for acute pericarditis are very heterogeneous. Our co-management between internists and cardiologists aims to diagnose earlier and easier curable diseases. Long-term follow-up remains of great interest, in order to diagnose later other disorders, which remained hidden, and to follow evolution of the population.

Publication types

  • English Abstract

MeSH terms

  • Acute Disease
  • Adult
  • C-Reactive Protein / analysis
  • Echocardiography
  • Electrocardiography
  • Female
  • Humans
  • Male
  • Pericarditis / diagnosis*
  • Pericarditis / etiology*
  • Prospective Studies
  • Troponin / blood

Substances

  • Troponin
  • C-Reactive Protein