Advances in medical therapy for pericardial diseases

Abstract

Medical therapy of pericardial diseases is moving forward to the road of evidence-based medicine and has improved in the last years because of the first randomized clinical trials in the area as well as new therapeutic options for recurrent pericarditis. Areas covered: The present review will focus on more recent advances with a special emphasis on the treatment of pericarditis, the area with more significant improvements in the last years. Medline/Pubmed Library were systematically screened with two specific key searches: 'pericarditis AND therapy' and 'pericardial effusion AND therapy'. The search was restricted to articles published in the last 5 years, in order to select the latest novelties in medical treatment and was restricted to 'human' studies and papers in English. Expert commentary: The anti-inflammatory therapy of pericarditis has been now well defined with first-line agents represented by nonsteroidal anti-inflammatory drugs plus colchicine, low-dose corticosteroids with slow tapering as second-line agents and for specific indications (e.g. specific systemic inflammatory diseases, renal failure, pregnancy, patients with interfering therapies such as oral anticoagulants), and third-line options in case of multiple recurrences (e.g. azathioprine, intravenous immunoglobulins, and especially anakinra).

Leptospirosis Presenting with Myopericarditis and Cardiogenic Shock

“…Supportive measures along with correction of coagulopathy is included in current management. Pericarditis should be managed with non-steroidal anti-inflammatory drugs, colchicine and low dose corticosteroids [11].…”

Suspected colchicine-induced late myocardial rupture occurring after the late presentation of acute inferior ST-elevation myocardial infarction

“…Colchicine, an anti-inflammatory agent widely used for the management of gout and autoimmune diseases, has emerged as a prevalent treatment modality for cardiovascular disease, given the wide implications of inflammation on atherosclerotic plaque formation [1]. Colchicine is currently the first drug of choice for pericarditis by inhibiting inflammatory response and preventing recurrent pericarditis [2][3][4]. Furthermore, myocardial infarction (MI) causes a severe inflammatory response that is important for cardiac repair by inducing scar formation and healing.…”

Acute Myopericarditis an Uncommon Presentation of Severe Leptospirosis - A Case Report and Literature Review

“…In 2010, a paper made in Peru, said that the prevalence of Leptospirosis in San Martin (a tropical State of Peru) is 64.6% [1]. Cardiac complications such as chest pain, arrhythmias, pulmonary edema and refractory shock have been reported in now well defined with first-line agents represented by nonsteroidal anti-inflammatory drugs plus colchicine, low-dose corticosteroids with slow tapering as second-line agents and for specific indications [5].…”