Acute Pericarditis: Likelihood Ratios

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 likelihood ratios of findings for Acute Pericarditis are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Pleuritic Chest Pain

2.3

0.4

Versus control patients with pericardial effusions

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

Chest CT

0.5

Pericardial thickening or enhancement. Versus control patients with pericardial effusions

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

Poorly Diagnostic Findings

Finding	+LR	-LR	Comments, Study
Elevated ESR	Sensitivity = 90%		Study: Acta Radiol. 2013 Dec 10. pii: 0284185113515866. PMID: 24327762
Elevated D-dimer	Sensitivity = 78%		Study: Acta Radiol. 2013 Dec 10. pii: 0284185113515866. PMID: 24327762
ECG	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	Sensitivity = 24%		Study: Acta Radiol. 2013 Dec 10. pii: 0284185113515866. PMID: 24327762
Friction rub, pericardial	Sensitivity = 9%		Thought to be 100% specific for acute pericarditis Study: Acta Radiol. 2013 Dec 10. pii: 0284185113515866. PMID: 24327762