Pericardial Disease

The pericardium is a thin fibrous sac/covering that surrounds and provides structural support to the heart.

Among the most important pericardial diseases include acute pericarditis, pericardial tamponade, and pericardial constriction.

What are the causes of pericardial disease?

Acute pericarditis Cardiac tamponade Pericardial constriction
  • Idiopathic
  • Infection
  • Renal failure
  • Myocardial infarction
  • Post-cardiac injury syndrome
  • Malignancy
  • Radiation
  • Trauma
  • Viral or bacterial infection of the pericardial sac
  • Cancer
  • Inflammation of the pericardial sac from a heart attack
  • Trauma
  • Autoimmune disease
  • Reactions to certain medicines or treatment
  • Metabolic causes e.g. chronic kidney failure
  • After open heart surgery
  • Cardiac surgery
  • Idiopathic constriction
  • Pericarditis
  • Mediastinal radiation therapy
  • Tuberculosis

What are the symptoms of pericardial disease?

Acute pericarditis Cardiac tamponade Pericardial constriction
  • Sharp chest pain that can radiate to the neck, arms, or left shoulder
  • Pericardial friction rub with high-pitched, scratchy or squeaky sound
  • Chest pain
  • Shoulder discomfort
  • Abdominal discomfort
  • Nausea
  • Dyspnoea
  • Anxious
  • Malaise
  • Fatigue
  • Decreased exercise tolerance
  • Peripheral oedema
  • Nausea
  • Abdominal discomfort
  • Ascites
  • Exertional dyspnoea
  • Orthopnoea
  • Paroxysmal nocturnal dyspnoea

How is pericardial disease diagnosed?

Acute pericarditis Cardiac tamponade Pericardial constriction
  • Medical history
  • Physical examination
  • Electrocardiography (ECG)
  • Echocardiogram
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Physical examination
  • Electrocardiography (ECG)
  • Chest radiography
  • Echocardiogram
  • Electrocardiography (ECG)
  • Lab test: brain natriuretic peptide (BNP) biomarker
  • Chest radiography
  • Echocardiogram

What are the treatment options for pericardial disease?

Acute pericarditis Cardiac tamponade Pericardial constriction
  • Medications e.g., combination therapy with colchicine and nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Prompt pericardial drainage by pericardiocentesis
  • Medical therapy e.g., diuretics and anti-inflammatory agents
  • Pericardiectomy (surgical removal of part or most of the pericardium)

What are the prevention tips for pericardial disease?

Pericardial disease like acute pericarditis and cardiac tamponade cannot be prevented. However, you can take steps to reduce your likelihood of having another acute episode or complications by:

  • Getting prompt treatment
  • Following the treatment plan advised by your doctor
  • Taking care of your heart by eating healthily, doing regular exercise, and keeping a healthy weight


  1. Pericardial disease. Circulation 2006;113(12):1622-32 [Accessed on 10 May 2022]
  2. Pericardial disease: diagnosis and management. Mayo Clin Proc. 2010;85(6):572-93 [Accessed on 10 May 2022]
  3. Pericardial disease. Available at [Accessed on 10 May 2022]
  4. Cardiac tamponade. Available at [Accessed on 10 May 2022]
  5. Prevention and treatment of pericarditis. Available at [Accessed on 10 May 2022]
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