Pericardial diseases are not uncommon. The diagnosis is not usually difficult and the prognosis is good, but uncertainty frequently arises in relation to their management. Clinical syndromes include acute inflammatory pericarditis, pericardial effusion, cardiac tamponade, and constrictive pericarditis. These syndromes sometimes coexist. Acute pericarditis is the most frequent pericardial...

Pericardial diseases are not uncommon. The diagnosis is not usually difficult and the prognosis is good, but uncertainty frequently arises in relation to their management. Clinical syndromes include acute inflammatory pericarditis, pericardial effusion, cardiac tamponade, and constrictive pericarditis. These syndromes sometimes coexist. Acute pericarditis is the most frequent pericardial syndrome; accordingly, it is extensively dealt with in this chapter, with emphasis on the clinical management. The advantages and limitations of invasive pericardial procedures and sophisticated laboratory studies in pericardial fluid and tissue are discussed, and recommendations for the indications of pericardiocentesis and pericardial biopsy are provided. Pericardial effusion, either as an isolated finding or accompanying other pericardial or extra-cardiac diseases, constitutes a frequent diagnostic challenge that is discussed separately. The correct diagnosis and management of pericardial constriction is an important issue as the concept of constrictive pericarditis has recently been expanded and, on the other hand, it is a curable disease if pericardiectomy is appropriately indicated. The main characteristics and management of the most important specific types of pericarditis are discussed and, finally, some rare types of pericardial diseases are commented on....