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Recurrent Pericarditis

Massimo Imazio1, Elena Gribaudo1, Fiorenzo Gaita1

  • 1University Division of Cardiology, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino and University of Torino, Torino, Italy.

Progress in Cardiovascular Diseases
|October 12, 2016
PubMed

Recurrent pericarditis is the most common and troublesome complication of pericarditis affecting 20% to 50% of patients. Its pathogenesis is often presumed to be immune-mediated, but additional investigations are needed to clarify the pathogenesis in order to develop etiology-oriented therapies. Imaging with computed tomography and especially cardiac magnetic resonance holds promise to help in the identification of more difficult cases and improve their management. Refractory recurrent pericarditis with corticosteroid dependence and colchicine resistance remain still an unsolved issue in search of new therapies, although old drugs such as azathioprine, intravenous immunoglobulins, and biological agents seem promising, but new randomized clinical trials are needed to confirm their role. Despite compromising the quality of life, idiopathic recurrent pericarditis has an overall good long-term outcome without mortality and significant risk of constrictive pericarditis evolution. The risk of constriction, the most feared complication, is related to the etiology and not the number of recurrences.

Keywords:
Cardiac magnetic resonanceDiagnosisEchocardiographyEtiologyPericarditisPrognosisRecurrent pericarditisTherapy

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