Unifying Concepts

Definitions and Diagnostic Criteria for Pericarditis

Pericardial syndromes include different clinical presentations of pericardial diseases with distinctive signs and symptoms that can be grouped in specific ‘syndromes’. The classical pericardial syndromes include pericarditis, pericardial effusion, cardiac tamponade and constrictive pericarditis.

Definitions and diagnostic criteria for pericarditis


Inflammatory pericardial syndrome to be diagnosed with at least 2 of the 4 following criteria:

  1. pericarditic chest pain
  2. pericardial rubs
  3. new widespread ST-elevation or PR depression on ECG
  4. pericardial effusion (new or worsening)

Additional supporting findings:
– Elevation of markers of inflammation (i.e. C-reactive protein, erythrocyte sedimentation
rate, and white blood cell count);
– Evidence of pericardial inflammation by an imaging technique (CT, CMR).

Pericarditis lasting for >4–6 weeks but <3 months without remission.

Recurrence of pericarditis after a documented first episode of acute pericarditis and a symptom-free interval of 4–6 weeks or longer (usually within 18–24 months, but a precise upper limit of time has not been established)
Pericarditis lasting for >3 months.

CMR = cardiac magnetic resonance; CT = computed tomography; ECG = electrocardiogram.



  1. Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2015;36(42):2921–2964. [Medline]
  2. McNamara N, Ibrahim A, Satti Z, Ibrahim M, Kiernan TJ. Acute pericarditis: a review of current diagnostic and management guidelines. Future Cardiol. 2019;15(2):119–126. [Medline]


Created Feb 29, 2020.

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