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Acute pericarditis: Update on diagnosis and management
1King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK tevfik.ismail@kcl.ac.uk.
Clinical Medicine (London, England)
|January 17, 2020
Summary
Acute pericarditis, often idiopathic, is treated with NSAIDs. Colchicine significantly reduces recurrence risk, with other options available for refractory cases.
Area of Science:
- Cardiology
- Infectious Diseases
Background:
- Acute pericarditis presents as chest pain, with idiopathic/viral causes predominant in developed countries.
- Tuberculosis is a significant cause in developing regions.
- Recurrence affects at least 25% of patients, necessitating effective management strategies.
Purpose of the Study:
- To outline current management strategies for acute pericarditis.
- To discuss treatment options for recurrent and refractory cases.
- To highlight the long-term prognosis of idiopathic acute pericarditis.
Main Methods:
- Review of current literature and treatment guidelines for acute pericarditis.
- Analysis of therapeutic options including NSAIDs, colchicine, steroids, anakinra, and surgery.
- Evaluation of recurrence rates and prognosis based on etiology.
Main Results:
- Non-steroidal anti-inflammatory drugs (NSAIDs) are the primary treatment.
- Colchicine (3 months) reduces recurrence by over 50% (NNT=4).
- Steroids and anakinra are second-line options; surgery for refractory cases.
Conclusions:
- Effective management of acute pericarditis involves NSAIDs and colchicine to prevent recurrence.
- Advanced therapies like anakinra and surgery are options for refractory disease.
- Idiopathic acute pericarditis generally has a good long-term prognosis with a low risk of constriction.
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