Acute pericarditis managed in the community
BioMG follows French guidelines. Adapt it to the guidelines and the tests available where you practise.
Suspected pericarditis: initial tests (the same day)
Not a laboratory test
- ECG, chest X-ray and echocardiography the same day (cardiologist or emergency department depending on access).
Laboratory tests
- CRP
- FBC
- Troponin (the same day: raised = myocardial involvement, hospital admission)
- Serum creatinine with eGFR (before NSAIDs and colchicine)
- HIV serologyif needednon-French guidelineViral serologies are not recommended routinely, except for HIV and HCV [1,2].
- Hepatitis C serologyif needednon-French guidelineViral serologies are not recommended routinely, except for HIV and HCV [1,2].
Also consider
- Acute coronary syndrome not excluded? If acute coronary syndrome cannot be excluded, see the "Acute chest pain seen in the practice" page.
Do not order
- Viral serologies (enterovirus, EBV, CMV, parvovirus…): not recommended routinely, with no therapeutic consequence; only HIV and HCV serology are exceptions [1,2]
- Extensive aetiological work-up (for example autoimmune, tuberculosis, cancer) in the absence of a poor prognostic factor: not mandatory, low yield; done in hospital in high-risk patients [1,2]
Follow-up of pericarditis treated in the community
At one week
- CRP
Then until normalisation (within the month, then at 3-6 months)
- CRP
On colchicine, during the first month (if renal or hepatic impairment)
- FBC with plateletsif neededRenal or hepatic impairment on colchicine: the SmPC (RCP) recommends, during the first month, an FBC with platelets and a reassessment of creatinine clearance [3].
- Serum creatinine (colchicine and renal or hepatic impairment)if neededRenal or hepatic impairment on colchicine: the SmPC (RCP) recommends, during the first month, an FBC with platelets and a reassessment of creatinine clearance [3].
Sources (7)
- Adler Y, Charron P, Imazio M, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 2015;36(42):2921-2964.
- Schulz-Menger J, Collini V, Gröschel J, et al. 2025 ESC Guidelines for the management of myocarditis and pericarditis. Eur Heart J. 2025;46(40):3952-4041.
- Résumé des caractéristiques du produit COLCHICINE OPOCALCIUM 1 mg, comprimé sécable. Base de données publique des médicaments, RCP mis à jour le 19/12/2025.
- Ministry of Defence (Royaume-Uni). Clinical Guidelines for Operations : Pericarditis. Dernière révision le 24/02/2026.
- Snyder MJ, Bepko J, White M. Acute pericarditis: diagnosis and management. Am Fam Physician. 2014;89(7):553-560.
- Peterson TA, Turner SP, Dolezal KA. Acute pericarditis: rapid evidence review. Am Fam Physician. 2024;109(5):441-446.
- Ehsan M, Ikram J, El Roumi J, Haider SW, Cremer PC, Wang TKM. Evolving guidelines in pericarditis: aligning practice with pathophysiology. JACC Adv. 2026;5(1):102509. Commentaire du consensus de l'American College of Cardiology (2025 Concise Clinical Guidance, J Am Coll Cardiol. 2025;86:2691-2719).