Recurrent Pericarditis

Abstract

Idiopathic recurrent pericarditis (IRP) is the most troublesome and common complication of acute pericarditis. The term “idiopathic” is used when infections (e.g., viruses or tuberculosis), neoplasms, and definite systemic diseases have been excluded. The diagnosis is based on the presence of typical symptoms and signs (pleuro-pericardial chest pain, pericardial rub, electrocardiographic alterations, pericardial effusion). Inflammatory markers and imaging techniques are confirmatory and help to manage the disease. Treatment includes the combination of nonsteroidal anti-inflammatory drugs (NSAIDs) at high dosage plus colchicine at low dosage; corticosteroids at medium-low dosages are often used, particularly in adult patients. In refractory cases, therapy with interleukin-1 inhibition has been remarkably effective.