Updates in diagnosis and treatment of acute pericarditis

Abstract

Background: Acute pericarditis is inflammation of the pericardium that begins suddenly, is often painful, and causes fluid and blood components to enter the pericardial space. Acute pericarditis has numerous causes. However, in developed countries, roughly 80 to 90% of cases are idiopathic; that is, no specific cause is identified after routine evaluation. It is assumed that these cases are viral. The remaining 10 to 20% of cases are most commonly associated with post–cardiac injury syndromes, connective-tissue diseases, or cancer [1]. The true incidence of the disease is unknown, it is estimated that it accounts for 5% of emergency department visits for chest pain in the absence of myocardial infarction [2]. New diagnostic strategies have been proposed for the triage of patients with pericarditis and when additional diagnostic investigations are required to perform [3]. Major advances have occurred in therapy with the first multicentre randomized clinical trials.Colchicine has been demonstrated as a first-line drug to be added to conventional antiinflammatory therapies in patients with a first episode of pericarditis or recurrences [3,4]. The information presented here, also contains a clinical case of a patient admited to the cardiology clinic with pericardial effusion in acute pericarditis. Conclusions: In the field of pericardial diseases there are a limited number of randomized controlled trials. Significant new data have become available since 2004, and the new version of recent guidelines published in 2015 have a great impact for clinical practice.