Pericardial disease: current diagnosis and management methods.

Diseases of the pericardium can be indolent or have a sudden onset. They may be primary, but more often are secondary to a systemic disease or previous therapy. Pericardial diseases imitate more common cardiac diseases and therefore can be difficult to diagnose. This paper's four case presentations illustrate use of recently developed methods that facilitate diagnosis. Magnetic resonance imaging is useful for the diagnosis of congenital absence of the pericardium. Echocardiography and computed tomography are useful for the diagnosis of pericardial cysts. Diagnosis of cardiac tamponade is aided by echocardiography, and Doppler echocardiography can help diagnose constrictive pericarditis. Effective management of pericardial diseases requires an understanding of the pathophysiology and natural history of each disease entity, knowledge of the individual patient, and realistic application of therapy.