European Association of Cardiovascular Imaging (EACVI) position paper: multimodality imaging in pericardial disease

Abstract

Although pericardial diseases are common in the daily clinical practice and can result in a significant morbidity and mortality, imaging of patients with suspected or known pericardial disorders remain challenging. Multimodality imaging is part of the management of pericardial diseases. Echocardiography, cardiac computed tomography, and cardiovascular magnetic resonance are often used as complementary imaging modalities. The choice of one or multiple imaging modalities is driven by the clinical context or conditions of the patient. The scope of the present document is to highlight the respective role of each technique according to the clinical context in the diagnosis and management of pericardial diseases.

Evaluation and Treatment of Pericarditis

“…[31][32][33][34][35][36] Contemporary diagnosis and management of pericarditis may best be accomplished with an integrated, multimodal approach. Two recent consensus documents, one from the American Society of Echocardiography 20 and one from the European Association of Cardiovascular Imaging, 21 provide imaging and diagnostic considerations based on expert opinion (level of evidence C). Multimodal imaging, including first-level imaging techniques such as echocardiography and chest x-ray ( Figure 2 and Figure 3) and second-level imaging techniques such as computed tomography and cardiac magnetic resonance, allows detection and confirmation of pericardial inflammation ( Figure 4), evaluation of pericardial thickness and assessment of the presence of constrictive and/or effusive-constrictive physiology, and establishment of the diagnosis of pericarditis in doubtful cases.…”

“…These techniques also allow identification of potentially reversible constriction due to pericardial inflammation. [20][21][22] Additional diagnostic testing is warranted depending on specific clinical suspicion (eTable 3 in the Supplement).…”

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

“…Niektóre dodatkowe badania znajdują zastosowanie w diagnostyce HF w zależ-ności od podejrzewanego specyficznego podłoża choroby (dodatkowa tab. 4.4) [71,[88][89][90][91][92][93][94], przy czym mogą one być zalecane wyłącznie wtedy, gdy ich wynik będzie miał wpływ na dalsze postępowanie.…”

A joint procedural position statement on imaging in cardiac sarcoidosis: from the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine, the European Association of Cardiovascular Imaging, and the American Society of Nuclear Cardiology

“…Several traditional and advanced echocardiographic approaches can be used with standard acquisition and interpretation protocols. [11][12][13][14][15][16][17][18] Stress echocardiography has a limited role in the diagnosis of cardiac sarcoidosis; it may be helpful to exclude epicardial coronary artery disease as a cause of left ventricular systolic dysfunction and focal regional wall motion abnormalities.…”