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Acute pericarditis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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

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