Management of Acute and Recurrent Pericarditis

Pericarditis refers to the inflammation of the pericardial layers, resulting from a variety of stimuli triggering a stereotyped immune response, and characterized by chest pain associated often with peculiar electrocardiographic changes and, at times, accompanied by pericardial effusion. Acute pericarditis is generally self-limited and not life-threatening; yet, it may cause significant short-term disability, be complicated by either a large pericardial effusion or tamponade, and carry a significant risk of recurrence. The mainstay of treatment of pericarditis is represented by anti-inflammatory drugs. Anti-inflammatory treatments vary, however, in both effectiveness and side-effect profile. The objective of this review is to summarize the up-to-date management of acute and recurrent pericarditis. • Pericarditis is the most common disease of the pericardium. Generally self-limiting, pericarditis can be fraught by a significant risk of acute complications and of recurrences. • Prompt diagnosis and appropriate treatment of acute pericarditis may reduce the risk of acute complications and recurrences. • New therapies, such as IL-1 blockers, show promising results in patients with recurrent/refractory pericarditis. • Future studies are needed to deepen the knowledge about pericarditis pathophysiology and provide targeted therapies.