Idiopathic Recurrent Acute Pericarditis

Abstract

Recurrent pericarditis is idiopathic in majority of patients and is frequently precipitated by a well-defined trigger such as injury or infection. Rigorous invasive diagnostic workup is not indicated unless risk factors for secondary causes are present. Idiopathic recurrent acute pericarditis (IRAP) can rarely be complicated by myocarditis, constrictive pericarditis, and pericardial tamponade. IRAP’s pathophysiology shares features with the autoinflammatory syndromes; hence, colchicine and anakinra, an interleukin 1 receptor antagonist, have proven effective therapeutic strategies in patients refractory or intolerant to nonsteroid anti-inflammatory medications and steroids.