Postpericardiotomy Syndrome Differential Diagnoses

Updated: Dec 30, 2020
  • Author: M Silvana Horenstein, MD; Chief Editor: Howard S Weber, MD, FSCAI  more...
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Diagnostic Considerations

The diagnosis of postpericardiotomy syndrome is made when two of the following five criteria are met [3] :

  • Fever

  • Pericardial or pleuritic chest pain

  • Pericardial or pleuritic friction rub

  • Pericardial effusion

  • Pericardial effusion with elevated levels of C-reaction protein (CRP)

The European Society of Cardiology established guidelines for the diagnosis and management of pericardial diseases in 2004. [27] In 2015, these guidelines were updated. [28]

Other resources that may be helpful include the following:

  • Fardman A, Charron P, Imazio M, Adler Y. European guidelines on pericardial diseases: a focused review of novel aspects. Curr Cardiol Rep. 2016 May. 18 (5):46. [QxMD MEDLINE Link]. [29]

  • Johnston DR. Surgical management of pericardial diseases. Prog Cardiovasc Dis. 2017 Jan - Feb. 59 (4):407-16. [QxMD MEDLINE Link]. [Full Text]. [30]

  • Klein AL, Abbara S, Agler DA, et al. American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with pericardial disease: endorsed by the Society for Cardiovascular Magnetic Resonance and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr. Sep 2013;26(9):965-1012.e15. [QxMD MEDLINE Link]. [31]

  • Imazio M, Adler Y, Ristic AD, Charron P. A new scoring system for the triage of cardiac tamponade. Expert Rev Cardiovasc Ther. Mar 2015;13(3):237-8. [QxMD MEDLINE Link]. [32]

  • Imazio M, Spodick DH, Brucato A, Trinchero R, Adler Y. Controversial issues in the management of pericardial diseases. Circulation. Feb 23 2010;121(7):916-28. [QxMD MEDLINE Link]. [33]

  • Khandaker MH, Espinosa RE, Nishimura RA, et al. Pericardial disease: diagnosis and management. Mayo Clin Proc. Jun 2010;85(6):572-93. [QxMD MEDLINE Link]. [Full Text]. [34]

  • Seferovic PM, Ristic AD, Maksimovic R, et al. Pericardial syndromes: an update after the ESC guidelines 2004. Heart Fail Rev. May 2013;18(3):255-66. [QxMD MEDLINE Link]. [35]

  • Snyder MJ, Bepko J, White M. Acute pericarditis: diagnosis and management. Am Fam Physician. Apr 1 2014;89(7):553-60. [QxMD MEDLINE Link]. [36]

  • Tamarappoo BK, Klein AL. Post-pericardiotomy syndrome. Curr Cardiol Rep. 2016 Nov. 18 (11):116. [QxMD MEDLINE Link]. [3]

  • Vogel-Claussen J, Elshafee ASM, Kirsch J, et al, for the Expert Panel on Cardiac Imaging. ACR Appropriateness Criteria dyspnea-suspected cardiac origin. J Am Coll Radiol. 2017 May. 14 (5S):S127-37. [QxMD MEDLINE Link][Full Text]. [30]

Differential Diagnoses