Pericarditis G049

Changes from previous Instruments

ICD Coding

• ICD-10-AM codes: I30, I31.0, I31.1, I01.0, and I09.2

Brief description

Pericarditis is inflammation of the pericardium, the sac surrounding the heart. Pericarditis may occur as an isolated condition or secondary to infection, autoimmune disease, malignancy, metabolic disorders, cardiac injury or other systemic disease. The condition may present as acute, recurrent, chronic or constrictive pericarditis. Chest pain is the most common presenting symptom.

Confirming the diagnosis

The diagnosis is made clinically, supported by history, physical examination and relevant investigations. Assessment may include:

• electrocardiography (ECG)
• inflammatory markers and other blood tests
• echocardiography
• cardiac imaging 

Clinical features may include pleuritic chest pain, pericardial rub, ECG changes or pericardial effusion. Management and confirmation are usually undertaken by a cardiologist or general physician.

Additional diagnoses covered by these SOPs

• Acute pericarditis
• Chronic pericarditis
• Recurrent pericarditis
• Constrictive pericarditis

Conditions not covered by these SOPs

• Pericardial effusion without pericardial inflammation #
• Haemorrhage from pericardial injury not associated with pericardial inflammation #
• Myocarditis #

* another SOP applies

# non- SOP condition 

Note: Pericarditis may occur in association with a pericardial effusion, although pericardial effusions may also occur independently of pericarditis.

Clinical onset

Clinical onset generally corresponds to the earliest time at which symptoms and signs attributable to pericarditis first become clinically evident. Acute pericarditis commonly presents with chest pain, often worsened by inspiration or positional change. Chronic or constrictive pericarditis may present with progressive dyspnoea, fatigue or features of heart failure.

Clinical worsening

Clinical worsening may be evidenced by recurrent or persistent inflammation, worsening pain, increasing pericardial effusion, constrictive physiology or impaired cardiac function. Management depends on identification and treatment of the underlying cause and associated complications. Delayed or inadequate treatment may contribute to recurrent, chronic or constrictive pericarditis. Cardiologist advice should be sought when assessing for possible clinical worsening and progression beyond the normal clinical course.