Specialized care for recurrent and complex pericardial disease
Pericardial disease can be difficult to diagnose and manage when symptoms persist or return. At the MedStar Health Pericardial Disease Program, our specialists evaluate the complete clinical picture—including symptoms, inflammatory markers, echocardiography, cardiac MRI, treatment history, and associated conditions—to understand what may be driving the disease and develop an individualized path forward.
Our program brings together expertise in pericardial disease, advanced cardiac imaging, rheumatology, infectious disease, cardiothoracic surgery, and clinical research for patients with recurrent, refractory, constrictive, effusive, and diagnostically challenging disease.
A comprehensive approach to complex pericardial disease
Patients with similar symptoms can be in very different disease states. Our specialists combine the medical history, physical examination, laboratory data, imaging, and previous treatment response to distinguish active inflammation from structural or hemodynamic disease, myocardial involvement, treatment-related issues, and other explanations for persistent symptoms.
Understand what is driving the symptoms
We evaluate the complete clinical picture to determine what may be contributing to persistent or recurrent symptoms.
Use advanced imaging to clarify the disease state
Echocardiography and cardiac MRI can help determine whether inflammation is active and whether there is effusion, constriction, or myocardial involvement.
Identify the disease phenotype
We assess whether the disease is inflammatory, noninflammatory, effusive, constrictive, myocardial, or mixed.
Match treatment to the condition
Treatment is individualized based on the disease state, prior response to treatment, coexisting conditions, and patient goals.
Reassess the response
Follow-up may integrate symptoms, biomarkers, echocardiography, and cardiac MRI when appropriate to assess treatment response, recurrence risk, and whether sustained remission has been achieved.
Program Director S. Waqas Haider, MD, and Gabby Weissman, MD, view image of the heart of a patient with pericardial disease.
Conditions we treat
The MedStar Health Pericardial Disease Program provides specialized evaluation and treatment for:
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Acute, recurrent, and persistent Pericarditis
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Refractory or treatment-dependent pericarditis
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Constrictive and effusive-constrictive pericarditis
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Pericardial effusion and cardiac tamponade
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Myopericarditis and perimyocarditis
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Post-cardiac injury syndromes, including Dressler syndrome
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Pericardial disease associated with autoimmune, inflammatory, infectious, or systemic illness
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Complex cases with discordant symptoms, biomarkers, imaging, or prior treatment response
Treatment tailored to the disease
Treatment is individualized according to disease phenotype, evidence of active inflammation, recurrence history, prior treatment response, coexisting conditions, and patient goals.
Depending on the clinical situation, care may include:
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Standard anti-inflammatory therapy, including colchicine and anti-inflammatory medications when appropriate
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Strategies to reduce prolonged corticosteroid exposure when clinically feasible
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Targeted interleukin-1 pathway therapy for selected patients with recurrent inflammatory disease
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Treatment of an underlying autoimmune, inflammatory, infectious, or systemic contributor in collaboration with the appropriate specialty
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Pericardiocentesis or other procedures for clinically significant pericardial effusion
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Cardiothoracic surgical evaluation for constrictive disease or other selected complex cases
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Clinical trials and emerging therapies when appropriate
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Longitudinal reassessment of disease activity, treatment response, recurrence risk, and treatment tapering
Multidisciplinary care for complex disease
Pericardial disease can involve cardiovascular imaging, systemic inflammation, infection, and cardiac surgery. Our program coordinates care across specialties when those perspectives may change the diagnosis, treatment strategy, or timing of an intervention.
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Advanced Cardiac Imaging
Imaging designed to answer important clinical questions
Advanced imaging is most valuable when it helps answer a specific clinical question. Our specialists integrate echocardiography and cardiac MRI with the patient's history, examination, laboratory data, and prior treatment response to determine whether disease is actively inflamed, hemodynamically significant, structurally constrictive, associated with myocardial involvement, or healing.
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Echocardiography
Echocardiography can assess:
- Pericardial effusion
- Tamponade physiology
- Ventricular interdependence
- Features of constrictive physiology
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Cardiac MRI
Cardiac MRI can help characterize:
- Pericardial inflammation
- Enhancement and edema
- Myocardial involvement
- Treatment response when clinically appropriate
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CT and hemodynamic assessment
CT and hemodynamic assessment can provide additional information about anatomy, calcification, and constrictive physiology in selected cases when additional information is needed.
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Rheumatology
Our specialists coordinate evaluation and treatment when autoimmune or systemic inflammatory disease may be contributing to pericardial inflammation or influencing treatment decisions.
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Infectious Disease
We collaborate with infectious disease specialists when an infectious cause is suspected, exposure history is complex, or immunosuppression changes the diagnostic or treatment approach.
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Cardiothoracic Surgery
Our cardiothoracic surgeons participate in the evaluation of constrictive pericarditis, recurrent or complicated effusions, pericardial biopsy or window, and pericardiectomy when appropriate.
Other specialists may be involved when the underlying disease or treatment requires additional expertise.
Our physicians
Location: Change location Enter your location
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Syed Waqas Haider, MBBS MD MPH
Cardiovascular Disease & Cardiology
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Gaby Weissman, MD
Cardiovascular Disease & Cardiology
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Research shaping what comes next
Clinical care and research are closely linked within the MedStar Health Pericardial Disease Program. Current multicenter studies address targeted therapy, recurrence after treatment withdrawal, natural history, patient experience, and long-term outcomes in recurrent pericarditis.
Current research
KPL-387
Phase 2/3 | NCT07010159
Investigational IL-1 pathway therapy in recurrent pericarditis.
Site principal investigator: Dr. Haider
MAVERIC
Phase 3 | NCT06708299
CardiolRx following planned discontinuation of long-term IL-1 blocker therapy.
Site principal investigator: Dr. Haider
RESONANCE
Registry | NCT04687358
Natural history, treatment patterns, patient experience, and outcomes in recurrent pericarditis.
Site investigator: Dr. Haider.
Frequently asked questions
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When should you see a pericardial disease specialist?
Specialty evaluation may be appropriate when:
- Pericarditis keeps coming back or symptoms never fully resolve.
- Symptoms continue despite standard anti-inflammatory treatment.
- Repeated or prolonged corticosteroid treatment has been needed.
- A targeted or steroid-sparing treatment strategy is being considered.
- Symptoms, inflammatory markers, imaging, and prior treatment response do not appear to fit together.
- There is concern for constriction, recurrent pericardial effusion, myocardial involvement, or another complex diagnosis.
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What should I do before my visit?
When available, please provide:
- Prior cardiac MRI and echocardiographic images and reports
- Relevant laboratory results and inflammatory markers
- Prior procedure, catheterization, and operative reports when applicable
- A medication and treatment timeline
- Records from prior emergency visits or hospitalizations related to pericardial disease
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What can I expect during my evaluation?
Your evaluation may include:
- Reviewing your clinical history and prior treatment course
- Reassessing prior imaging and determining whether additional testing would add value
- Clarifying whether active inflammation, effusion, constriction, myocardial involvement, or another process is present
- Coordinating other specialty input when needed
- Establishing a clear treatment and follow-up plan
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When can constriction be reversible?
Constrictive physiology does not always represent the same biological state. In selected patients, imaging and the clinical trajectory can help determine whether active inflammation may still be contributing and whether medical therapy should be considered before or alongside surgery.
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What does remission look like?
Symptoms are important, but remission may also require evidence that inflammation has settled and disease is stable. Follow-up may integrate symptoms, biomarkers, echocardiography, and cardiac MRI when appropriate, including decisions about when long-term therapy can be reduced.
Insurance
MedStar Health accepts most major health insurance plans. If you are uncertain as to whether your individual health insurance plan is accepted at MedStar Health, please call your insurance company.