Acute Pericarditis Diagnosis (ESC 2015 Criteria)
Diagnoses acute pericarditis (≥ 2 of 4 ESC criteria) and flags high-risk features that warrant hospital admission. Guides aspirin/NSAID + colchicine therapy.
Score interpretation
Fewer than 2 of the 4 ESC criteria.
→ Consider other causes; raised CRP or imaging evidence of pericardial inflammation can support the diagnosis — reassess.
At least 2 of 4 criteria and no high-risk feature.
→ Adults: aspirin 750-1000mg 8h for 1-2 weeks + colchicine 0.5mg BD 3 months; activity restriction until symptom-free; outpatient management; avoid NSAIDs if TB/post-MI suspected; NSAIDs (ibuprofen 600mg 8h) + colchicine; rest; avoid competitive sports for 3 months; echocardiogram; CRP-guided therapy duration; cardiology follow-up. Children: use a children's formulary.
At least 2 of 4 criteria and a high-risk feature.
→ Hospital admission; cardiac monitoring; echocardiogram; exclude bacterial/TB aetiology; consider pericardiocentesis if tamponade; hold NSAIDs and start IV steroids if bacterial not excluded
Interpretation bands for the Pericarditis (ESC). Apply clinical judgement and local guidance.
References
- Adler Y et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 2015;36(42):2921-2964.
- Imazio M et al. Indicators of poor prognosis of acute pericarditis. Circulation. 2007;115(21):2739-2744.
Related
Curated clinical cross-links plus same-class fallbacks.
- Colchicine (Pericarditis / Post-MI Inflammation) · Pericarditis / Coronary Inflammation
- Colchicine (Acute Gout) · Anti-Inflammatory (Microtubule Inhibitor)
- Metoprolol (IV/Oral — Cardiology) · Beta-Blocker
- Aspirin (Antiplatelet — ACS/PCI) · Antiplatelet / ACS
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Dobutamine (Acute HF / Stress Echo) · Inotrope / Acute Heart Failure
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.