Difficulties in the management of an acute pericarditis (hospitalized after 5 weeks of evolution)

Pericarditis is clinically heterogeneous, with acute, subacute or chronic manifestations, and within each subset, with variable intensity of symptoms, from asymptomatic to a highly symptomatic disease. The etiology is also heterogeneous, often without a suggestive symptomatology. Depending or not on the etiology, sometimes through immune mechanisms, there can be some important complications, like recurrent/chronic pericarditis, life threatening acute tamponade or disabling constrictive pericarditis. The prognosis is highly dependent on a correct and precocious diagnosis (etiology included) and therapy. When the initial response to therapy is inadequate, the management of chronic or recurrent pericarditis is very difficult and also very important, with failure often leading to pericardial constriction, a difficult to treat complication of pericarditis.