Pericardial diseases

Pericardial diseases are relatively common in clinical practice and may occur either as isolated disease or as a manifestation of a systemic disorder. A targeted etiological search should be directed to the most likely cause on the basis of the clinical background, epidemiological issues, or specific presentations. Clinicians should consider neoplastic, tuberculous, and purulent causes, as well as forms related to a systemic disease. Most cases remain idiopathic, and empiric anti-inflammatory therapy should be considered as first-line therapy in most cases with the possible addition of colchicine in the setting of inflammatory pericardial diseases especially those that relapse or do not respond to first-line drugs. The prognosis is determined by the underlying cause, with bacterial and neoplastic forms having the worst prognosis. Contemporary optimal management of the patient with suspected pericardial disease often requires the selection and integration of different imaging modalities.