Differential diagnosis of pericarditis. Part I: Anatomical and physiological characteristics of the pericardium, chest pain syndrome, and pericardial effusion

Inflammatory involvement of the pericardium (ranging from effusion to wall thickening), whether accompanied by chest pain or not, presents challenges not only in diagnosis and therapy, but also in examination, due to the diverse etiologies of pericardial disease. This article reviews current approaches to the diagnosis and treatment of patients with pericardial effusion and pericarditis, which may manifest as chest pain or proceed asymptomatically. Anatomical and physiological characteristics of the pericardium, mechanisms of effusion development and tamponade are described. Diagnostic algorithms for chest pain syndrome typical for pericarditis and asymptomatic effusion are provided. The article includes recommendations for differential diagnosis of pericardial inflammation causes, an analysis of complication risks, and indications for anti-inflammatory therapy and interventional procedures. Emphasis is placed on optimizing patient management through risk stratification and clinical performance.