Conflict of interest: noneAcute pericarditis is a common disease caused by inflammation of the pericardium, usually benign and self-limited and can occur as an isolated or as a manifestation of a systemic disease entity. Represents 5% of all causes of chest pain in the emergency room. The main etiology are viral infections, although it can also be secondary to systemic diseases and infections. The main complication of acute pericarditis is pericardial effusion, triggering a cardiac tamponade. The first line of treatment is the use of anti-inflammatory and or acetylsalicylic acid. Most patients have a good initial response to an NSAID associated to colchicine and became asymptomatic within a few days. This review article seeks to contemplate the main clinical findings and armed investigation to optimize the diagnosis of this important disease, as well as addressing their therapeutic management.Keywords: acute pericarditis, pericardial effusion, chest pain, colchicine. clinical definitionThe pericardium is a fibroelastic sac composed of two layers (visceral and parietal), separated by a virtual space called the pericardial cavity, which is filled with 15 to 50 mL of plasma ultrafiltrate in healthy subjects. Acute pericarditis is a common disease caused by inflammation of the pericardium, usually benign and selflimited, and may occur as an isolated entity or as a manifestation of a systemic disease.The real incidence and prevalence of pericarditis is difficult to quantify. Necropsy studies suggest a prevalence of approximately 1%. It affects mainly young males (aged between twenty and fifty years) without previous pathologies and represents 5% of all causes of chest pain in the emergency room. In developed countries, about 80-90% of cases are idiopathic, assuming that its main etiology is viral infection, although it can also be secondary to systemic diseases and infections.

BackgroundInternational studies have reported the value of the clinical profile and laboratory findings in the diagnosis of constrictive pericarditis. However, Brazilian population data are scarce.ObjectiveTo assess the clinical characteristics, sensitivity of imaging tests and factors related to the death of patients with constrictive pericarditis undergoing pericardiectomy.MethodsPatients with constrictive pericarditis surgically confirmed were retrospectively assessed regarding their clinical and laboratory variables. Two methods were used: transthoracic echocardiography and cardiac magnetic resonance imaging. Mortality predictors were determined by use of univariate analysis with Cox proportional hazards model and hazard ratio. All tests were two-tailed, and an alpha error ≤ 5% was considered statically significant.ResultsWe studied 84 patients (mean age, 44 ± 17.9 years; 67% male). Signs and symptoms of predominantly right heart failure were present with jugular venous distention, edema and ascites in 89%, 89% and 62% of the cases, respectively. Idiopathic etiology was present in 69.1%, followed by tuberculosis (21%). Despite the advanced heart failure degree, low BNP levels (median, 157 pg/mL) were found. The diagnostic sensitivities for constriction of echocardiography and magnetic resonance imaging were 53.6% and 95.9%, respectively. There were 9 deaths (10.7%), and the risk factors were: anemia, BNP and C reactive protein levels, pulmonary hypertension >55 mm Hg, and atrial fibrillation.ConclusionsMagnetic resonance imaging had better diagnostic sensitivity. Clinical, laboratory and imaging markers were associated with death.