AttendMe Owl Logo
AttendMe
Sign In
All Pathways
CardiologyManagement

Pericarditis Management (ACC 2025)

Pericarditis Management (ACC 2025): Acute Pericarditis → First-Line: Dual Anti-inflammatory → Activity Restriction.

Pathway Overview

10 steps

Algorithm Steps

10 total

  1. 01Start

    Acute Pericarditis

    ≥2 of: pleuritic pain, friction rub, ECG changes, effusion

  2. 02Action

    First-Line: Dual Anti-inflammatory

    NSAID + Colchicine

    • Aspirin 750-1g q8h OR Ibuprofen 600mg q8h
    • PLUS Colchicine 0.5mg QD-BID
    • Duration: 1-2 weeks NSAID, 3mo colchicine
    • PPI for GI protection
  3. 03Action

    Activity Restriction

    Minimum 1 month

    • Avoid strenuous exercise
    • Athletes: 3 months
  4. 04Decision

    Response to First-Line?

  5. If Yes
    1. 05Outcome

      Resolved

      Complete colchicine course

    2. 06Outcome

      Follow-Up

      Echo, inflammatory markers, symptom monitoring

    If No
    1. 07Warning

      Refractory/Recurrent

      2025 Update: IL-1 inhibitors BEFORE steroids

    2. 08Action

      IL-1 Inhibitors (Class I)

      Preferred for inflammatory phenotype

      • Rilonacept 320mg load → 160mg/wk SC
      • OR Anakinra 100mg SC daily
      • Duration: ≥12-18 months
      • Evidence: RHAPSODY trial
    3. 09Warning

      Pericardiectomy

      Refractory or constrictive

    4. Path rejoins step 06Shared downstream outcome
    5. 10Action

      Corticosteroids

      Second-line (promotes chronicity)

      • Low-dose prednisone
      • Slow taper over months
      • Avoid if possible
    6. Path rejoins step 09Shared downstream outcome

Guideline Source

2025 ACC Expert Consensus on Pericarditis

DOI: 10.1016/j.jacc.2025.05.023View Guideline

Clinical Safety Information

Clinical Decision Support — Not a Substitute for Clinical Judgment

Individual patient factors may require deviation from these recommendations.

Known Limitations

  • Does not address purulent/tuberculous pericarditis
  • Immunosuppression protocols simplified
  • Pericardiectomy criteria not detailed

Contraindicated Populations

pediatric

Applicable Regions

USEU

EU: ESC 2015 guidelines older but similar principles

US: ACC 2025 - IL-1 inhibitors BEFORE corticosteroids

Version 1Next review: 2028-06-01

Related Cardiology Pathways

ACLS Bradycardia Algorithm (AHA 2025)

Emergency

ACLS Tachycardia with Pulse Algorithm (AHA 2025)

Emergency

AFib Anticoagulation Decision (ESC 2024)

Management

Aortic Stenosis Management (ESC/EACTS 2025)

Management

Next steps

Finish the workflow by opening the most relevant calculator, then convert the session into a live account when you are ready.

Calculator

CHA₂DS₂-VASc Score

Stroke risk stratification in atrial fibrillation

Open page

Compare

AttendMe.ai vs UpToDate

See how this pathway workflow compares against UpToDate.

Open page

Commercial

Start free

Run the pathway in a live AttendMe account with citations and tracked usage.

Start free

Related Resources

All Clinical PathwaysClinical CalculatorsAI Chat with Auto-Detection

Frequently Asked Questions

What is the Pericarditis Management (ACC 2025)?

The Pericarditis Management (ACC 2025) is a management clinical algorithm for Cardiology. It provides a structured decision tree to guide clinical decision-making, based on 2025 ACC Expert Consensus on Pericarditis.

What guideline is the Pericarditis Management (ACC 2025) based on?

This algorithm is based on 2025 ACC Expert Consensus on Pericarditis (DOI: 10.1016/j.jacc.2025.05.023).

What are the limitations of the Pericarditis Management (ACC 2025)?

Known limitations include: Does not address purulent/tuberculous pericarditis; Immunosuppression protocols simplified; Pericardiectomy criteria not detailed. Individual patient factors may require deviation from these recommendations.

Get AI-Powered Analysis Alongside This Algorithm

In AttendMe.ai, the Pericarditis Management (ACC 2025) appears automatically when your clinical question matches — alongside evidence from 3M+ peer-reviewed articles.

Try AttendMe Free