Contemporary diagnosis and treatment of recurrent pericarditis

ABSTRACT

Introduction: Acute pericarditis is frequently complicated with recurrences, which represent a diagnostic and therapeutic challenge for the physician, a bothersome trouble for patients. An incorrect treatment of pericarditis may cause further recurrence of symptoms, while an incorrect diagnosis may cause either a prolonged symptoms course with a possible risk of chronic constriction, or useless and potentially harmful treatments.

Areas covered: This review will focus on the most useful and recent diagnostic tools for recurrent pericarditis. Medline/Pubmed Library were screened with specific key search: ‘recurrent AND pericarditis’. The research was restricted to papers published in the last 5 years (2015–2019) and papers in English language, in order to appraise the latest advances in diagnostic assessment.

Expert opinion: An accurate diagnosis of recurrent pericarditis is critical to provide timely and appropriate treatment of symptoms and prevention of further episodes. Diagnosis is made in case of recurrent symptoms associated with a documented evidence of pericardial inflammation. Further studies are needed to develop newer diagnostic tools aimed at identification of a predominant auto-inflammatory of auto-immune mechanism, which is essential to tailor the treatment.

KEYWORDS:

• Recurrent pericarditis
• diagnosis
• auto-inflammatory
• auto-immune

Article highlights

• Acute pericarditis is frequently complicated with recurrences.

• A correct management of the first episode is critical for the prevention of recurrences.

• A typical diagnosis of recurrent pericarditis is made in case of symptoms relapse associated with a documented evidence of pericardial inflammation.

• An incorrect diagnosis of recurrent pericarditis may cause either a prolonged symptoms course with a possible risk of chronic constriction, or useless and potentially harmful treatments.

• Acute and recurrent pericarditis should always be treated according to evidence-based best clinical practice to prevent further symptoms occurrence.

Declaration of interest

M Imazio is on the Advisory board for SOBI. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.