European Association for Cardio-Thoracic Surgery (EACTS) outlined triage of a patient with acute pericarditis.
Major predictors of poor prognosis:
(1) fever > 38.0°C
(2) subacute onset
(3) large pericardial effusion
(4) cardiac tamponade
(5) lack of response to aspirin or NSAIDS after 7 days of therapy
Suspicion of a high-risk cause can serve as an additional major predictor.
Minor predictors of poor prognosis:
(1) myopericarditis
(2) immunosuppression
(3) trauma
(4) oral anticoagulant therapy
Parameters:
(1) clinical evidence of pericarditis
(2) predictors of poor prognosis
(3) response to anti-inflammatory agents (NSAIDS, other)
|
Evidence of Pericarditis
|
Predictors of Poor Prognosis
|
Response to NSAIDS
|
Triage
|
|
no
|
NA
|
NA
|
no pericarditis; look for other diagnosis
|
|
yes
|
yes
|
NA
|
high risk
|
|
yes
|
no
|
no
|
moderate risk
|
|
yes
|
no
|
yes
|
low risk
|
where:
• Failure to respond to NSAIDS is a criteria for both high risk and moderate risk.
|
Risk Group
|
Management
|
|
high
|
admit to hospital and identify etiology
|
|
moderate
|
admit to hospital and identify etiology
|
|
low
|
outpatient follow-up
|
