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Pericarditis through the prism of military medicine. Lecture for practicing physicians

https://doi.org/10.22328/2413-5747-2025-11-2-15-27

EDN: SVZPQN

Abstract

The pericardium as a structure of the heart and pericarditis as a disease began to be mentioned at the dawn of our era in close association with military medicine. The upsurge of pathology in modern times, associated with the COVID-19 pandemic, was also first noted in a military hospital. Today and in the years to come, the relevance of the topic of pericarditis will inevitably surface in the differential diagnosis of chest pain in patients with chest wounds and contusions, as well as in military personnel who have repeatedly carried acute respiratory viral infections on their feet or who have panic attacks. In 10 years since the release of the latest European guidelines for the management of pericarditis, there have been significant changes in the ideas about pathogenesis, and new possibilities for diagnosis and therapy of the disease have emerged. The lecture contains data that provide the most adequate knowledge about pericarditis with comments from the authors on the subtle points and persistent problems in the management of these patients.

About the Authors

V. B. Simonenko
Military Medical Academy (branch, Moscow)
Russian Federation

Vladimir B. Simonenko – Dr. of Sci. (Med.), professor of the department of emergency treatment

107392, Moscow, Malaya Cherkizovskaya Str., 7



Z. N. Sukmarova
V. A. Nasonov Research Institute of Rheumatology
Russian Federation

Zulfiya N. Sukmarova – Cand. of Sci. (Med.), researcher 

115522, Kashirskoe highway, 34, А



References

1. Spoddick D. H. Medical History of the Pericardium. The Hairy Hearts of Hoary Heroes. The American Journal of cardiology, 1970, Vol. 26, рр. 26, 447–454.

2. Shestov V. I. Development of the activities of the Kronstadt Naval Hospital for the 259th anniversary of its foundation. Leningrad: Kronstadt Naval Hospital, 1967 (In Russ.)].

3. Sosin V. V. History of domestic naval medicine in dates and facts. St. Petersburg; 1996 (In Russ.)].

4. Transcript of the meeting of the second scientific conference of the Naval Medical Academy. Saint Petersburg 05.07.1948 (In Russ.)].

5. Sukmarova Z. N., Simonenko V. B., Ibragimova F. M., Demyanenko A. V. Exudative pericarditis as a new specific symptom of SARS-CoV-2. Clinical Medicine, 2021, Vol. 99, No. 3, pp. 192–197 (In Russ.)]. doi: 0.30629/0023-2149-2021-99-3-192-197.

6. Sukmarova Z. N., Potapov E. V., Saidova M. A., Ovchinnikov Yu. V., Gromov A. I. Pericardial changes associated with SARS-CoV-2 infection. Prospective observation in a covid center. REJR 2022, Vol. 12, No. 4, рр. 30–47 (In Russ.)]. doi: 10.21569/2222-7415-2022-12-4-30-47.

7. Sukmarova Z. N., Ovchinnikov Yu. V., Gudima G. O., Ibragimova F. M., Afonina O. V., Machkalyan K. E. Increased echo signal from the pericardium in recipients of SARS-CoV-2 vaccines. Infectious diseases, 2021, Vol. 19, No. 4, рр. 43–50 (In Russ.)]. doi: 10.20953/1729-9225-2021-4-43-50.

8. Sukmarova Z. N., Ibragimova F. M., Afonina O. V., Simonenko V. B. Recurrent course of post-inflammatory cardiopathy: lessons from past epidemics. Clinical Medicine, 2022, Vol. 100, No. 2-3, рр. 97–107 (In Russ.)]. doi: 10.30629/0023-2149-2022-100-2-397-107.

9. Sukmarova Z. N., Simonenko V. B., Nasonov E. L. Treatment of patients with pericarditis with anti-inflammatory drugs. Clinical Medicine, 2022, Vol. 100, No. 11-12, рр. 509–519 (In Russ.)]. doi: 10.30629/0023-2149-2022-100-11-12-509-519.

10. Sukmarova Z. N., Simonenko V. B., Nasonov E. L. Therapy of pericarditis with colchicine, interleukin-1 antagonists, and immunosuppressants. Clinical Medicine, 2023, Vol. 101, No. 1, рр. 6–17 (In Russ.)]. doi: 10.30629/0023-2149-2023-101-1-6-17.

11. Jaworska-Wilczynska M., Trzaskoma P., Szczepankiewicz A. A., Hryniewiecki T. Pericardium: structure and function in health and disease. Folia Histochem Cytobiol, 2016, Vol. 54, No. 3, рр. 121–125. doi: 10.5603/FHC.a2016.0014.

12. Vogiatzidis K., Zarogiannis S. G., Aidonidis I., Solenov E. I., Molyvdas P. A., Gourgoulianis K. I., Hatzoglou C. Physiology of pericardial fluid production and drainage. Front Physiol, 2015, Vol. 6, pp 62. doi:10.3389/fphys.2015.00062.

13. Mahabadi N., Goizueta A. A., Bordoni B. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Mar 24, 2024. Anatomy, Thorax, Lung Pleura And Mediastinum.

14. Oliver K.A., Ashurst J. V. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Jul 24, 2023. Anatomy, Thorax, Phrenic Nerves.

15. Adler Y., Charron P., Imazio M., et al; ESC Scientific Document Group. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC) Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J, 2015, Vol. 36, No. 42, pp. 2921–2964.

16. Nasonov E. L., Sukmarova Z. N., Popkova T. V., Belov B. S. Problems of immunopathology and prospects for pharmacotherapy of idiopathic recurrent pericarditis: use of an interleukin 1 inhibitor (Anakinra). Scientific and practical rheumatology, 2023, Vol. 61, No. 1, pp. 47–61 (In Russ.)]. doi: 10.47360/1995-4484-2022-47-61.

17. Xu B., Harb S. C., Cremer P. C. New Insights into Pericarditis: Mechanisms of Injury and Therapeutic Targets. Curr Cardiol Rep, 2017, Vol. 19, No. 7, pp. 60. doi: 10.1007/s11886-017-0866-6.

18. Malik A. A., Lloyd J. W., Anavekar N. S., Luis S. A. Acute and Complicated Inflammatory Pericarditis: A Guide to Contemporary Practice. Mayo Clin Proc, 2024, Vol. 99, No. 5, pp. 795–811. doi: 10.1016/j.mayocp.2024.01.012.

19. Ungureanu R., Cobilinschi C., Cotae A.M., et al. // Hemorrhagic Cardiac Tamponade-An Unusual Threat in the COVID-19 Recovery Phase. Medicina (Kaunas), 2022, Vol. 59, No. 1, pp. 3. doi: 10.3390/medicina59010003.

20. Proceedings of the VIII All-Russian Interdepartmental Scientific and Practical Conference “Thoracic Surgery during the Second Military Military Operation: from the Battlefield to Rehabilitation”. 19-20.02.2025 (In Russ.)].

21. Mantovani A., Dinarello C. A, Molgora M., Garlanda C. Interleukin-1 and Related Cytokines in the Regulation of Inflammation and Immunity. Immunity, 2019, Vol. 50, No. 4, pp. 778–795. doi: 10.1016/j.immuni.2019.03.012.

22. Puntmann V. O., Martin S., Shchendrygina A., et al. Long-term cardiac pathology in individuals with mild initial COVID-19 illness. Nat Med, 2022, Vol. 28, No. 10, pp. 2117–2123. doi: 10.1038/s41591-022-02000-0.

23. Sukmarova Z. N., Dobrovolskaya S. V., Shitov V. N., Saidova M. A. New echocardiography parameters to help in the management of constrictive pericarditis. REJR, 2024, Vol. 14, No. 4, pp. 93–108 (In Russ.)]. doi: 10.21569/2222-7415-2024-14-4-93-108.

24. Sukmarova Z. N., Saidova M. A., Ovchinnikov Yu. V. Exudative pericarditis in the pathogenesis of cardiac rhythm disturbances in COVID-19: a series of clinical cases. Cardiovascular Therapy and Prevention, 2022, Vol. 21, No. 2, pp. 3021 (In Russ.)]. doi: 10.15829/1728-8800-2022-3021.

25. Mascolo R., Bizzi E., Martelli M., et al. Old and New Biomarkers in Idiopathic Recurrent Acute Pericarditis (IRAP): Prognosis and Outcomes. Curr Cardiol Rep, 2025, Vol. 27, pp. 7. doi: 10.1007/s11886-024-02170-y.

26. Schiavone W. A., Majdalany D. S. Don’t judge a book by its cover: Unusual presentations of pericardial disease. Cleve Clin J Med, 2025, Vol. 92, No. 2, pp. 109–116. doi: 10.3949/ccjm.92a.24065.

27. Boniface N., Kley J., Lisko J., Mikolich B., Mikolich J.R. Non-cardiac chest pain: Is it really? Circulation, 2014, Vol. 130, A12863.

28. Belov B. S. Infectious pericarditis. Consilium medicum, 2009, Vol. 5, pp. 117–122 (In Russ.)].

29. Puntmann V. O., Carerj M., Wieters I., et al. Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). JAMA Cardiol, 2020, Vol. 5, No. 11, pp. 1265–1273. doi: 10.1001/jamacardio.2020.3557.

30. Campos C., Prokopich S., Loewen H., Sanchez-Ramirez D. C. Long-Term Effect of COVID-19 on Lung Imaging and Function, Cardiorespiratory Symptoms, Fatigue, Exercise Capacity, and Functional Capacity in Children and Adolescents: A Systematic Review and Meta-Analysis. Healthcare (Basel), 2022, Vol. 10, No. 12, pp. 2492. doi: 10.3390/healthcare10122492.

31. Lenz C., Slack M. P. E., Shea K. M., et al. Long-Term effects of COVID-19: a review of current perspectives and mechanistic insights. Critical Reviews in Microbiology, 2023, Vol. 50, No. 3, pp. 315–328. doi: 10.1080/1040841X.2023.2190405.

32. Imazio M., Brucato A., Lazaros G., et al. Anti-inflammatory therapies for pericardial diseases in the COVID-19 pandemic: safety and potentiality. J Cardiovasc Med (Hagerstown), 2020, Vol. 21, No. 9, pp. 625–629. doi: 10.2459/ JCM.0000000000001059.

33. Bao C., Liu X., Zhang H., Li Y., Liu J. Coronavirus dis-ease 2019 (COVID-19) CT findings: a systematic review and meta-analysis. J Am Coll Radiol, 2020, Vol. 17, No. 6, pp. 701–709. doi: 10.1016/j.jacr.2020.03.006.

34. Sukmarova Z. N., Parshin V. V., Shishimorov A. A., Gromov A. I. Polyserositis as a negative prognostic factor for COVID-19. Observations of City Clinical Hospital No. 52 at the beginning and end of the pandemic. Medical Visualization, 2025, Vol. 2, рр. 20–28 (In Russ.)]. doi: 10.24835/1607-0763-1496.

35. Basso C., Leone O., Rizzo S., et al. Pathological features of COVID-19-associated myocardial injury: a multicentre cardiovascular pathology study. Eur Heart J, 2020, Vol. 41, No. 39, pp. 3827–3835. doi: 10.1093/eurheartj/ehaa664.

36. Ramadan M. S., Bertolino L., Zampino R. Monaldi Hospital Cardiovascular Infection Study Group. Cardiac sequelae after coronavirus disease 2019 recovery: a systematic review. Clin Microbiol Infect, 2021, Vol. 27, No. 9, pp. 1250–1261. doi: 10.1016/j.cmi.2021.06.015.

37. Sugak A. B. Pericarditis: etiology, classification, clinical features, diagnostics, treatment. Part 1. Issues of modern pediatrics, 2009, Vol. 2, pp. 77–84 (In Russ.)].

38. Cosyns B., Plein S., Nihoyanopoulos P., et al.; European Association of Cardiovascular Imaging (EACVI); European Society of Cardi-ology Working Group (ESC WG) on Myocardial and Pericardial diseases. European Association of Cardiovascular Imaging (EACVI) position paper: Multimodality imaging in pericardial disease. Eur Heart J Cardiovasc Imaging, 2015, Vol. 16, No. 1, pp. 12–31. doi: 10.1093/ehjci/jeu128.

39. Mikolich J., Kley J., Boniface N., et al. Are new diagnostic criteria for pericarditis needed? J Am Coll Cardiol, 2014, Vol. 63, S 12.

40. Nosov V. P., Koroleva L.Yu., Amineva N. V., Zlobin M. V., Borovkov N. N. Publ. Diseases of the pericardium. Monograph. Nizhny Novgorod: Nizhny Novgorod State Medical Academy, 2016, 190 p.; ill. (In Russ)].

41. Diaz-Arocutipa C., Saucedo-Chinchay J., Imazio M. Peri-carditis in patients with COVID-19: a systematic review. J Cardiovasc Med (Hagerstown), 2021, Vol. 22, No. 9, pp. 693–700. doi: 10.2459/JCM.0000000000001202.

42. Li P., Shi A., Lu X., et al. // Incidence and impact of acute pericarditis in hospitalized COVID-19 patients. J Am Heart Assoc, 2023, Vol. 12, e028970. doi:10.1161/JAHA.122.028970.

43. Welch T. D. Constrictive pericarditis: diagnosis, management and clinical outcomes. Heart, 2018, Vol. 104, No. 9, pp. 725–731. doi: 10.1136/heartjnl-2017-311683.

44. Vistarini N., Chen C., Mazine A., et al. Pericardiectomy for Constrictive Pericarditis: 20 Years of Experience at the Montreal Heart Institute. Ann Thorac Surg, 2015, Vol. 100, No. 1, pp. 107–13. doi: 10.1016/j.athoracsur.2015.02.054.

45. Mironenko V. A., Kuts E. V., Makarenko V. N., Rienmuller R. Diagnosis and surgical treatment (cardiac decortication) for viral constrictive epicarditis. Anal of surgery, 2017, Vol. 22, No. 4, pp. 222–226 (In Russ.)].

46. Bondarev G. A., Temirbulatov V. I., Budanov E. Yu. Heart injuries based on materials from a multidisciplinary hospital. Modern problems of science and education, 2021, Vol. 6 (In Russ.)]. doi:10.17513/spno.31330.

47. Bhatia R. T., Marwaha S., Malhotra A. Exercise in the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) era: a question and answer session with the experts endorsed by the section of sports cardiology & exercise of the European Association of Preventive Cardiology (EAPC). Eur. J. Prev. Cardiol, 2020, Vol. 27, No. 12, pp. 1242–1251. doi: 10.1177/2047487320930596.

48. Kim J. H., Levine B. D., Phelan D. Coronavirus disease 2019 and the athletic heart: emerging perspectives on pathology, risks, and return to play. JAMA Cardiol, 2021, Vol. 6, No. 2, pp. 219–227. doi: 10.1001/jamacardio.2020.5890.

49. Imazio M., Sukmarova Z. N., Nasonov E. L. Complex issues of pericarditis management. In anticipation of the release of updated recommendations of the European Society of Cardiology. Cardiology, 2024, Vol. 64, No. 10, pp. 57–61 (In Russ.)]. doi: 10.18087/cardio.2024.10.n2738.

50. Sato K., Ayache A., Kumar A., et al. Improvement in left ventricular mechanics following medical treatment of constrictive pericarditis. Heart, 2021, Vol. 107, No. 10, pp. 828–835. doi: 10.1136/heartjnl-2020-317304.


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For citations:


Simonenko V.B., Sukmarova Z.N. Pericarditis through the prism of military medicine. Lecture for practicing physicians. Marine Medicine. 2025;11(2):15-27. (In Russ.) https://doi.org/10.22328/2413-5747-2025-11-2-15-27. EDN: SVZPQN

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