{
  "abstract": "Background Pericarditis is typically diagnosed on the basis of clinical criteria (chest pain, pericardial rub, ECG changes and pericardial effusion). However, the diagnosis can be challenging as these findings are often transient. We evaluated the clinical utility of cardiac magnetic resonance (CMR) in the diagnosis of pericarditis.Methods Consecutive patients referred for the evaluation of pericarditis by CMR between 2010 and 2024 to a tertiary hospital in Sydney, Australia, were retrospectively screened. Patients were stratified according to the presence (CMR-pos) or absence (CMR-neg) of pericardial late gadolinium enhancement (LGE) and analysed for differences in clinical patterns, C reactive protein (CRP), troponin and imaging findings.Results Among 2530 patients referred for CMR, 88 patients (age 39 years (IQR 24–52), 37% female) were identified as referrals for pericarditis/myopericarditis. 43/88 (49%) patients had CMR-proven pericarditis and 45/88 (51%) did not. Among CMR-pos patients, 13/43 (30%) did not meet 2015 ESC diagnostic criteria. Conversely, 24/45 (47%) CMR-neg patients met criteria for a clinical diagnosis. CRP and pericardial effusion were associated with positive scans and more severe pericardial disease (CRP 178 mg/L (IQR 98–253) and 88% had pericardial effusion in moderate/severe pericardial LGE vs 35 mg/L (IQR 7–63) and 19% in minimal/mild, p<0.05 for both). CRP level demonstrated moderate predictive value for identifying CMR-pos scans with a sensitivity of 56% and a specificity of 84% for CRP levels above 50 mg/L. CMR-pos patients not meeting clinical criteria tended to have more subacute and non-idiopathic disease despite similar levels of pericardial LGE when compared with those with clinically apparent pericarditis.Conclusions CMR reliably identifies pericardial inflammation in patients not meeting clinical criteria and excludes significant inflammation in a large proportion of patients with an initial clinical diagnosis. CRP level and the presence of pericardial effusion may help identify patients who are likely to have CMR evidence of pericarditis.",
  "authors": [
    {
      "affiliations": [
        "Cardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia",
        "Cardiology, Kantonsspital St Gallen, St. Gallen, Switzerland"
      ],
      "name": "Sebastian Hasslacher"
    },
    {
      "affiliations": [
        "Cardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia",
        "The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Leonard Kritharides"
    },
    {
      "affiliations": [
        "The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia",
        "Cardiology Department, Peter Munk Cardiac Centre, Toronto, Ontario, Canada"
      ],
      "name": "Christopher Yu"
    },
    {
      "affiliations": [
        "Cardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia",
        "The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Malcolm Anastasius"
    },
    {
      "affiliations": [
        "Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia"
      ],
      "name": "Michael Chan"
    },
    {
      "affiliations": [
        "Cardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia",
        "The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "John Yiannikas"
    },
    {
      "affiliations": [
        "Radiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia"
      ],
      "name": "Joseph Trieu"
    },
    {
      "affiliations": [
        "Cardiology, Concord Repatriation General Hospital, Concord, New South Wales, Australia",
        "The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia"
      ],
      "name": "Christopher Naoum"
    }
  ],
  "title": "Added value of cardiac magnetic resonance to clinical diagnostic criteria in the diagnosis of pericarditis: a retrospective cohort study",
  "uid": "81bd3007-9ec1-5472-a21b-7998af5e10a2"
}