Acute and Recurrent Pericarditis

摘要

Acute and recurrent pericarditis are common clinical problems. Treatment should be targeted at the specific etiology, but this is often not reached with a conventional approach, and the majority of cases still remains idiopathic. Comprehensive and systematic implementation of new techniques for pericar-dial fluid and tissue analyses might be useful to develop an etiology-based treatment, although treatment is not altered by these techniques in viral and idiopathic cases. Moreover pericardioscopy may enhance pericardial sampling efficiency, facilitate direct instillation of treatments into the pericardial space. At present these investigations are not widely available or practiced, and their implementation seems advisable for high risk cases refractory to a full trial of conventional medical therapy in well-experienced tertiary referral centres. Clinical risk stratification of acute pericarditis may be useful to select patients who should be admitted to hospital, and in whom complete evaluation should be performed to identify causes that require specific therapy.