Tuberculous pericarditis differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Differentiating [Disease name] from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].

OR

As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].

Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]

On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6].

Diseases		Clinical manifestations								Para-clinical findings						Gold standard	Additional findings
	History	Symptoms			Physical examination
										Lab Findings	Imaging				Histopathology
		Chest pain	Fever	Cough	Edema/Ascites	JVP	Heart/Lung sounds	Hepatomegaly	Splenomegaly	Lab 1	CXR	CT Scan	MRI	Echo/Sono
Constrictive pericarditis
Tuberculosis	Close contact with TB+ person	+	+	+	±	↑	Friction rub S4 Distant heart sounds Fine/coarse crackles upon auscultation of the lung Pericardial knock Pericardial rub	+	−	Miled anemia Leukocytosis	Pleural effusion Pericardial calcification Pericardial thickening Pericardial effusion Evidence of pulmonary TB Enlarged cardiac silhouette	Calcification of the pericardium Thickened pericardium Pericardial effusion Back flow of blood into the IVC and hepatic veins (in contrast CT scan)	Pericardial effusion Pericardial thickening Mediastinal and tracheobronchial lymphadenopathy (with hilar sparing) Bowing of the interventricular septum toward the left ventricle during diastole	Pericardial effusion Pericardial thickening Increased right ventricular dimensions Decreased left ventricular dimensions Abnormal septal motion Flattening of the left ventricular posterior wall during diastol Dilated inferior vena cava Dilated atrium	Acid fast bacilli	Pericardiocentesis Pericardial biopsy (If we can't find acid fast bacilli in sputum or pericardial fluid)
Idiopathic/Viral	Recent common cold	+	±	±
Post cardiac surgery	Cardiac surgery
Post radiation	Radiation
Connective tissue disease
Malignancy	History of known malignancy	+	±	−	Ankle edema	↑	Pericardial knock Pericardial rub Distant heart sounds	+	−	Increased: Creatine kinase Cardiac troponin-I LDH Serum myoglobin SGOT (AST)	Pericardial calcifications Enlarged cardiac silhouette
Mesothelioma
Chronic renal failure
Asbestosis
Restrictive cardiomyopathy
Amyloidosis
Sarcoidosis
Hemochromatosis
Sclerodema
Endomyocardial fibrosis
Carcinoid heart disease
Post radiation
Diabetic cardiomyopathy
Hurler
Gaucher
Fabry
Wegener
Metastatic malignancies