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Acute Pericarditis: Sensitivity and Specificity

Introduction: Inflammation of the pericardium, most commonly viral in nature though can also be caused by bacteria, uremia, tuberculosis, or autoimmune diseases (e.g. Lupus).

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Tags: Cardiac Problem Inflammatory Tag this Diagnosis.

The sensitivity and specificity of findings for Acute Pericarditis are listed below. See the left navigation bar to change the display.

Specific Findings

Finding SensitivitySpecificity Comments, Study
Chest CT Edit 54%91%

Pericardial thickening or enhancement. Versus control patients with pericardial effusions

Study: Acta Radiol. 2013 Dec 10. pii: 0284185113515866. PMID: 24327762

Sensitive Findings

Finding SensitivitySpecificity Comments, Study
Elevated ESR Edit Sensitivity = 90%

Study: Acta Radiol. 2013 Dec 10. pii: 0284185113515866. PMID: 24327762

Poorly Diagnostic Findings

Finding SensitivitySpecificity Comments, Study
Pleuritic Chest Pain Edit 70%70%

Versus control patients with pericardial effusions

Study: Acta Radiol. 2013 Dec 10. pii: 0284185113515866. PMID: 24327762

Elevated D-dimer Edit Sensitivity = 78%

Study: Acta Radiol. 2013 Dec 10. pii: 0284185113515866. PMID: 24327762

ECG Edit Sensitivity = 50%

Classically, 4 stages are described:

  • Stage I: Concave-up ST segment elevation; PR segment depression
  • Stage II: Normal ST segments, T-wave flattening
  • Stage III: T-wave inversion
  • Stave IV: Resolved T-wave inversion
  • Study: Am Fam Physician. 1998 Feb 15;57(4):699-704. PMID: 9490993

    Pleuritic chest pain relieved by sitting up Edit Sensitivity = 24%

    Study: Acta Radiol. 2013 Dec 10. pii: 0284185113515866. PMID: 24327762

    Friction rub, pericardial Edit Sensitivity = 9%

    Thought to be 100% specific for acute pericarditis

    Study: Acta Radiol. 2013 Dec 10. pii: 0284185113515866. PMID: 24327762