Evaluation, management, and treatment of acute pericarditis and myocarditis in the emergency department

Acute pericarditis is often found in association with acute myocarditis, mainly because viral infection is the most common cause of both. However, the different prognostic implications and specific risk of complications of each entity obliges us to distinguish between them whenever possible. The evaluation and management of an emergency department patient suspected of having acute pericarditis or myocarditis must rest on 4 pillars: clinical presentation, electrocardiography, biomarkers of heart disease, and transthoracic echocardiography. These initial assessments will indicate the level of risk of complications and guide the decisions of whether to admit the patient or not and start specific treatment. This review provides an up-to-date discussion of the main diagnostic and therapeutic considerations in acute pericarditis and myocarditis. (Emergencias 2010;22:301-306)