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 when the pericardium, the thin sac-like membrane surrounding the heart, becomes inflamed. This condition can occur as an isolated condition or be the result of an underlying disease or injury. In many cases, the exact cause of pericarditis is unknown (idiopathic). The initial episode of pericarditis may be followed by relapsing or recurrent pericarditis. A common symptom of this condition is chest pain.

Confirming the diagnosis

The diagnosis is made clinically based on the history and characteristic examination and electrocardiography findings.

The relevant medical specialist is a cardiologist or general medical 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 can be associated with a pericardial effusion but the pericardial effusions can also occur without the presence of pericarditis.

Clinical onset

For acute pericarditis, the time interval after exposure to the relevant risk factors is often short whilst there is usually a very long time interval after exposure to potential risk factors for chronic and constrictive pericarditis. The clinical onset can be taken from the first presentation of symptoms, which often involves chest pain (worse with deep breathing). Other symptoms of acute pericarditis may include fever, muscle ache and malaise, though these can often relate to the underlying cause. Chronic and constrive pericarditis may present with shortness of breath or heart failure. Patients may be symptomatic for some time before a diagnosis is made. 

Clinical worsening

Most cases of idiopathic acute pericarditis (cause unknown) resolves on its own without requiring specific medical treatment. In other cases, management of pericarditis requires identifying the underlying cause and treating it accordingly. Acute pericarditis will generally respond to medications and simple treatment for most cases. Occasionally, more invasive procedures or surgery may be required. The development of recurrent or chronic pericarditis is uncommon following treated acute pericarditis but can occur in up to 30% of untreated patients. The development of chornic pericarditis may be contributed to by multiple risk factors so clinical worsening factors could be considered for such cases.