Acute Pericarditis Diagnosis (ESC 2025) — free guideline decision tool
2025 ESC criteria (a compatible clinical presentation plus additional criteria) classify acute pericarditis as definite, possible or not supported and flag high-risk features warranting admission.
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Implements the decision logic from published clinical guidelines.
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No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Clinical presentation (entry condition, not counted) | B Other presentation compatible with pericarditis (clinician-judged: atypical chest pain, dyspnoea in the elderly, AF or other supraventricular arrhythmia, right heart failure signs) |
|---|---|
| Pericardial friction rub | No |
| ECG: new PR depression or widespread ST-segment elevation | No |
| Elevated CRP | Yes |
| New or worsening pericardial effusion | No |
| CMR: pericardial oedema and/or LGE | Yes |
| High-risk features (list [Pending update]) | None |
→Acute pericarditisDefinite
- Classification (ESC 2025)：Acute pericarditis: definite (ESC 2025) — compatible clinical presentation with 2 additional criteria (≥2).
- Additional criteria：2/5 (rub/ECG/CRP/effusion/CMR)
- Note：Clinical presentation is atypical (clinician-judged); exclude acute coronary syndrome, pulmonary embolism, aortic dissection and similar conditions first.
| Clinical presentation (entry condition, not counted) | A Typical pericarditic chest pain (sharp/pleuritic, relieved by sitting forward, worse on inspiration/lying down) |
|---|---|
| Pericardial friction rub | No |
| ECG: new PR depression or widespread ST-segment elevation | No |
| Elevated CRP | No |
| New or worsening pericardial effusion | No |
| CMR: pericardial oedema and/or LGE | No |
| High-risk features (list [Pending update]) | None |
→Acute pericarditisNot supported
- Classification (ESC 2025)：Acute pericarditis: not supported (ESC 2025) — a compatible clinical presentation plus at least 1 additional criterion is not met.
- Additional criteria：0/5 (rub/ECG/CRP/effusion/CMR)
- Risk stratification：→ most can be managed as outpatients with empiric anti-inflammatory therapy and follow-up
Common questions
What is Acute Pericarditis Diagnosis (ESC 2025)?
2025 ESC criteria (a compatible clinical presentation plus additional criteria) classify acute pericarditis as definite, possible or not supported and flag high-risk features warranting admission.
How is Acute Pericarditis Diagnosis (ESC 2025) calculated? What is the core formula?
With a compatible clinical presentation, count additional criteria (pericardial rub, new PR depression or widespread ST-segment elevation, elevated CRP, new or worsening pericardial effusion, pericardial oedema and/or LGE on CMR): ≥ 2 definite, 1 possible, 0 or no compatible presentation not supported.
When is Acute Pericarditis Diagnosis (ESC 2025) used?
[Pending update] Some thresholds, grades and management recommendations on this page that conflict with current guidelines or are unverified are temporarily hidden pending verification against the guideline text.
What are the key clinical points for Acute Pericarditis Diagnosis (ESC 2025)?
Corticosteroids are avoided first-line in idiopathic/viral pericarditis because they increase recurrence. Troponin should be checked to detect myopericardial involvement, which changes risk and management. The pericardium is electrically silent; ECG changes (PR depression, widespread ST-segment elevation) imply concomitant myocardial inflammation, so evaluate for myocarditis and differentiate from STEMI.
What are the limits and cautions when using Acute Pericarditis Diagnosis (ESC 2025)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
Does Acute Pericarditis Diagnosis (ESC 2025) upload patient data? Where is it calculated?
Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
How is Acute Pericarditis Diagnosis (ESC 2025) calculated in practice? Can you show a worked example?
Inputs: Clinical presentation (entry condition, not counted) B Other presentation compatible with pericarditis (clinician-judged: atypical chest pain, dyspnoea in the elderly, AF or other supraventricular arrhythmia, right heart failure signs), Pericardial friction rub No, ECG: new PR depression or widespread ST-segment elevation No, Elevated CRP Yes, New or worsening pericardial effusion No, CMR: pericardial oedema and/or LGE Yes, High-risk features (list [Pending update]) None → Result: Acute pericarditis Definite（Classification (ESC 2025): Acute pericarditis: definite (ESC 2025) — compatible clinical presentation with 2 additional criteria (≥2)., Additional criteria: 2/5 (rub/ECG/CRP/effusion/CMR), Note: Clinical presentation is atypical (clinician-judged); exclude acute coronary syndrome, pulmonary embolism, aortic dissection and similar conditions first.） Inputs: Clinical presentation (entry condition, not counted) A Typical pericarditic chest pain (sharp/pleuritic, relieved by sitting forward, worse on inspiration/lying down), Pericardial friction rub No, ECG: new PR depression or widespread ST-segment elevation No, Elevated CRP No, New or worsening pericardial effusion No, CMR: pericardial oedema and/or LGE No, High-risk features (list [Pending update]) None → Result: Acute pericarditis Not supported（Classification (ESC 2025): Acute pericarditis: not supported (ESC 2025) — a compatible clinical presentation plus at least 1 additional criterion is not met., Additional criteria: 0/5 (rub/ECG/CRP/effusion/CMR), Risk stratification: → most can be managed as outpatients with empiric anti-inflammatory therapy and follow-up）
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2025 ESC criteria (a compatible clinical presentation plus additional criteria) classify acute pericarditis as definite, possible or not supported and flag high-risk features warranting admission.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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