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Sunday 5 July 2026

Peer Reviewed

GP emergency management

A young woman with chest pain and ECG changes

Anthony Van Assche, Gordian Fulde

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Recent articles on:
Pericardial disorders

A long-term consequence of pericarditis

A young woman with chest pain and ECG changes

Central sharp chest pain: what is the diagnosis?

Abstract

A woman presents with chest pain and her ECG suggests a diagnosis of pericarditis but acute myocardial infarction needs to be ruled out.

Key Points

Acute pericarditis is diagnosed by the presence of at least two of the following criteria: typical chest pain, pericardial friction rub, suggestive ECG changes, and new or worsening pericardial effusion.
Patients with suspected pericarditis and/or chest pain should be sent by ambulance to the emergency department of their local hospital to rule out acute coronary syndrome.
Echocardiography is still the gold-standard test for pericarditis.
The ECG changes in acute pericarditis differ from that of acute myocardial infarction in several ways.
Treatment of pericarditis depends on the underlying cause.
Indicators for poor prognosis in patients with pericarditis include temperature above 38^oC, subacute onset over weeks, immunosuppression and large pericardial effusion.
Picture credit: © iStockphoto/Patrick Heagney. Model used for illustrative purposes only.