Abstract 17256: Utility of Echocardiography in Acute and Recurrent Pericarditis

Abstract

Background: Pericarditis usually presents with sharp chest pain, and other diagnostic features include pericardial rub, typical EKG changes (diffuse ST elevation and PR depression), and the presence of pericardial effusion (PEff). Echocardiography (ECHO) is the first-line imaging modality in pericarditis. It helps to identify PEff, constrictive physiology, and wall motion abnormalities. We sought to characterize ECHO features in a large cohort of patients with acute (AP) and recurrent pericarditis (RP). Methods: Data were collected retrospectively for patients with acute and recurrent pericarditis. Pericarditis was diagnosed based on the European Society of Cardiology pericardial disease guidelines. ECHOs were reviewed for relevant features and findings. Chi-square test statistics were used to compare AP and RP. Results: A total of 323 consecutive patients with RP (68%) and AP (32%) was identified from January 2015 to December 2018. The median age was 52 years 56% were female. Of the total patients, the most common finding on ECHO was PEff (42%). Of the patients having PEff, 65 (20%) had trivial, 42 (13%) small, 19 (6%) moderate, and 6 (2%) had large effusion. Other findings included constrictive physiology (20%), thickened pericardium (4%), and echo wall motion abnormality (3%). AP patients had higher number of PEff compared to RP (51% vs 38%; [X 2 =4.1, p=0.043]. Increased pericardial thickness was only found in patients with RP (6% in RP vs 0% in AP; [X 2 =6, p=0.014]. All the other findings were similar across RP and AP Conclusion: The most common echocardiographic finding in acute and recurrent pericarditis patients is pericardial effusion followed by constrictive physiology and thickened pericardium. Pericardial effusion appears to be more frequent in AP patients as compared to RP. These findings may be useful in the diagnostic workup of pericarditis.