Newer Aspects of Diagnostic and Therapeutic Management of Acute Idiopathic Pericarditis

¹ The Cardiovascular Section of the Brooklyn Veterans Administration Hospital, the State University of New York, Downstate Medical Center, Brooklyn, New York
² The Isaac Albert Research Institute of the Jewish Chronic Disease Hospital and the Department of Pathology, Albert Einstein College of Medicine, Brooklyn, N.Y.

Comparative serial studies of the fibrinogen polymerization test, with several acute phase reactants such as the C-reactive protein, the erythrocyte sedimentation rate and plasma fibrinogen concentration, and also the antistreptolysin-O titer were carried out to explore their relative usefulness, for the differential diagnosis of non-specific rheumatic and tuberculous pericarditis.

A consistently positive F.P. test indicated the presence, and mirrored the course, of rheumatic and idiopathic pericarditis, while it was negative in tuberculous pericarditis. Of the acute phase reactants only the ESR was abnormal to a comparable degree in all conditions studied. It seems, therefore, that the F.P. test can serve as a valuable aid in the diagnosis of idiopathic pericarditis.

The F.P. test appears, furthermore, of value for the differential diagnosis between atypical myocardial infarction and acute nonspecific pericarditis, particularly, when used concomitantly with the serum GO-transaminase or aldolase tests.

The treatment of pericarditis is discussed and the value of steroid therapy in nonspecific and rheumatic pericarditis of severe degree is emphasized.

The F.P. test provides a particularly useful criterion for the efficacy of therapy since it appears not to be suppressed by salicylate or steroid therapy and reflects the activity of the disease.