Prognosis

Prognosis generally depends on the underlying cause and disease severity. Features associated with a poor prognosis include:[1][13]​​​[16]​​[38][39][40][57]

  • Major risk factors (associated with poor prognosis after multivariate analysis):

    • Evidence of a large pericardial effusion (i.e., diastolic echo-free space >20 mm)

    • High fever (i.e., >38°C [>100.4°F])

    • Subacute course (i.e., symptoms over several days without a clear-cut acute onset)

    • Failure to respond within 7 days to a non-steroidal anti-inflammatory drug

  • Minor risk factors (based on expert opinion and literature review):

    • Pericarditis associated with myocarditis (myopericarditis)

    • Immunosuppression

    • Trauma

    • Oral anticoagulant therapy.

The presence of any one major or minor risk factor warrants hospitalisation and a full evaluation for aetiology of the pericardial disease.[1] See the Management recommendations section.

Acute idiopathic pericarditis is generally a self-limited disease in 70% to 90% of patients, with no significant complications or recurrence. Purulent pericarditis is uniformly fatal if untreated and has a mortality of 40% with treatment.[55]​

Complications are frequent in bacterial and tuberculous forms of the disease (constriction occurs in up to 30% to 50%).

Uraemic pericarditis generally responds to intensive dialysis. Effusions are common with neoplastic pericarditis and are often recurrent and difficult to manage.[1][2][12]

Around 15% to 30% of patients with pericarditis experience recurrence.[79]

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