When does pericarditis merit a workup for autoimmune or inflammatory disease?

Abstract

Pericarditis is in most cases a onetime disease simply treated with antiinflammatory drugs. It requires no extensive workup for systemic inflammatory or autoimmune disease. Further evaluation is required for patients who have recurrent pericarditis resistant to conventional therapy or pericarditis with manifestations of systemic disease. ■ ACUTE PERICARDITISPericardial disease has different presentations: acute, recurrent, constrictive, effusiveconstrictive, and pericardial effusion with or without tamponade. Acute pericarditis is the most common of these and can affect people of all ages. The typical acute manifestations are chest pain (usually pleuritic), a pericardial friction rub, and widespread ST-segment elevation on the electrocardiogram. 1,2 The chest pain tends to be sharp and long-lasting; it radiates to the trapezius ridge and increases during respiration or body movements.Acute pericarditis usually responds to an anti-inflammatory drug such as colchicine 0.6 mg/day for 3 months, a nonsteroidal antiinflammatory drug such as ibuprofen 600 mg three times a day for 10 days, and in advanced resistant cases, an oral corticosteroid. 3,4 Most often, pericarditis is either idiopathic or occurs after a respiratory viral illness. Much

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