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Related Concept Videos

Pericarditis III: Medical Management01:17

Pericarditis III: Medical Management

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The primary objectives of managing pericarditis are to determine the underlying cause, provide effective therapy for treatment and symptom relief, and promptly detect signs and symptoms of cardiac tamponade. The following outlines the essential aspects of medical management for pericarditis:ObjectivesDetermine the Cause: Identifying the underlying cause of pericarditis is crucial for targeted treatment. Causes include viral infections, autoimmune diseases, post-cardiac injury syndrome, and...
389
Pericarditis I: Introduction01:22

Pericarditis I: Introduction

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Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...
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Pericarditis II: Clinical Features and Diagnostic Tests01:19

Pericarditis II: Clinical Features and Diagnostic Tests

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Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
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Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
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Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

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Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
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Myocarditis III: Medical Management01:14

Myocarditis III: Medical Management

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Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
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Author Spotlight: Ultrasound-Guided Needle Release Combined with Corticosteroid Injection for the Treatment of Supinator Syndrome
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Does colchicine decrease the rate of recurrence of acute idiopathic pericarditis treated with glucocorticoids?

Aviv Mager1, Yeela Talmor1, Chava Chezar Azzerad1

  • 1Department of Cardiology, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Journal of Cardiology
|December 5, 2017
PubMed
Summary

Adding colchicine to prednisone for acute pericarditis did not reduce recurrence rates. Prednisone may interfere with colchicine's protective effects, suggesting alternative treatment strategies are needed for recurrent pericarditis.

Keywords:
Acute idiopathic pericarditisColchicineNon-steroidal anti-inflammatory agentsPrednisoneRecurrence

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Area of Science:

  • Cardiology
  • Internal Medicine
  • Pharmacology

Background:

  • Acute pericarditis is traditionally treated with NSAIDs or glucocorticoids.
  • Colchicine addition to treatment regimens can decrease pericarditis recurrence.
  • Limited data exist on glucocorticoid effects on colchicine's efficacy.

Purpose of the Study:

  • To investigate the impact of colchicine on acute idiopathic pericarditis recurrence rates in patients pretreated with prednisone.
  • To evaluate if prednisone use affects the recurrence-reducing benefits of colchicine.

Main Methods:

  • A retrospective study analyzed 199 patients with acute idiopathic pericarditis treated between 2004-2014.
  • Patients received either glucocorticoids (prednisone) or non-steroidal therapy, with or without colchicine.
  • Recurrence frequencies were assessed over a median follow-up of 48 months.

Main Results:

  • The overall recurrence rate was 26.6% (53/199 patients).
  • Patients receiving prednisone and colchicine had a significantly higher recurrence rate (40.5%) compared to NSAID/aspirin and colchicine (18.2%) or any non-steroidal therapy (22.6%).
  • No significant difference in recurrence was observed between prednisone alone (25%) and non-steroidal therapy groups.

Conclusions:

  • Colchicine combined with prednisone does not lower the risk of pericarditis recurrence.
  • Prednisone appears to diminish the beneficial effects of colchicine in preventing pericarditis recurrence.