Acute Pericarditis.
N Engl J Med. 2014 Dec 18;371(25):2410-2416
Authors: LeWinter MM
Abstract
Key Clinical Points Acute Pericarditis The diagnosis of acute pericarditis requires at least two of the following symptoms or signs to be present: typical chest pain, pericardial friction rub, typical electrocardiographic changes, and pericardial effusion. In developed countries, 80 to 90% of cases are idiopathic and presumed to be viral. Evaluation includes a medical history and laboratory tests to help determine whether a specific cause is present, a chest radiograph, and an echocardiogram to determine whether there is an effusion. In response to treatment with a combination of a nonsteroidal antiinflammatory drug (NSAID) and colchicine, 70 to 90% of cases resolve completely; treatment with glucocorticoids should be avoided, if possible, because they increase the risk of recurrence. Patients with recurrent pericarditis should be treated with repeated courses of an NSAID and colchicine; if treatment with glucocorticoids cannot be avoided, moderate initial doses followed by gradual tapering provide the best outcomes.
PMID: 25517707 [PubMed - as supplied by publisher]