Acute pericarditis is the inflammation of the pericardium.
At least one in four patients are at risk of recurrence.
Principles of management:
- non-steroidal anti-inflammatory drugs (NSAIDs) remain the cornerstone of treatment
- addition of 3 months of colchicine can more than halve the risk of recurrence (number needed to treat = four) (1)
- evidence shows that in patients with first attack of pericarditis associated with myocardial involvement, colchicine was safe and efficacious for the reduction of recurrences (2)
- low-dose steroids can be helpful second-line agents for managing recurrences as adjuncts to NSAIDs and colchicine but should not be used as first-line agents
Reference:
- Ismail TF. Acute pericarditis: Update on diagnosis and management. Clin Med (Lond). 2020 Jan;20(1):48-51.
- Collini V, De Martino M, Andreis A, et al Efficacy and safety of colchicine for the treatment of myopericarditis Heart Published Online First: 18 January 2024. doi: 10.1136/heartjnl-2023-323484