Prognostic markers in pericarditis

Prognostic markers in pericarditis

Poor prognostic markers in pericarditis according to a JACC State-of-the-Art Review were [1]:

  1. Fever more than 38 degrees Centigrade
  2. Large pericardial effusion measuring more than 20 mm on echocardiography
  3. Presence of cardiac tamponade – it may be noted that tamponade need not be related to the size of effusion, rather with the rapidity of collection
  4. Lack of response to anti-inflammatory therapy in one week

A previous study of 453 patients had evaluated the indicators of poor prognosis in acute pericarditis [2]. In that study, fever more than 38 degrees Centigrade, subacute course, large effusion or tamponade, and aspirin or NSAID failure were the indicators of specific causes and complications. Specific cause was identified in only 76 of the 453 patients. These were autoimmune in 33 patients, neoplastic in 23 patients, tuberculous in 17 patients and purulent in 3 patients. Other potential causes associated with increased risk as per literature are immunosuppression, trauma, oral anticoagulant therapy and myopericarditis [2].


  1. Chiabrando JG, Bonaventura A, Vecchié A, Wohlford GF, Mauro AG, Jordan JH, Grizzard JD, Montecucco F, Berrocal DH, Brucato A, Imazio M, Abbate A. Management of Acute and Recurrent Pericarditis: JACC State-of-the-Art Review. J Am Coll Cardiol. 2020;75(1):76-92.
  2. Imazio M, Cecchi E, Demichelis B, Ierna S, Demarie D, Ghisio A, Pomari F, Coda L, Belli R, Trinchero R. Indicators of poor prognosis of acute pericarditis. Circulation. 2007 May 29;115(21):2739-44.