Contemporary management of pericardial diseases
- 1 May 2012
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Current Opinion in Cardiology
- Vol. 27 (3), 308-317
- https://doi.org/10.1097/hco.0b013e3283524fbe
Abstract
Pericardial diseases are relatively common in clinical practice, either as isolated disease or as manifestation of a systemic disorder. The aim of the present study is to review more recent updates on their contemporary management. The cause of pericardial diseases is varied according to the epidemiologic background, patient population, and clinical setting. Most cases remain idiopathic, and empiric anti-inflammatory therapy should be considered as first-line therapy in most cases with the possible adjunct of colchicine in the setting of inflammatory pericardial diseases, especially relapsing or not responding to first-line drugs. A triage has been proposed to select high-risk cases requiring admission and specific cause search. The prognosis of pericardial diseases is essentially determined by the cause. The most feared complication is constriction, the risk of which is higher in bacterial forms, intermediate for postpericardiotomy syndromes and systemic inflammatory diseases, low for viral and idiopathic cases. Chronic constriction has a definite surgical therapy, whereas transient cases should be recognized and may be reversible with empirical anti-inflammatory therapy. Contemporary management of pericardial diseases is largely empirical, although first clinical trials and new studies on diagnostic modalities and prognosis of pericardial diseases are bringing the contemporary management of pericardial diseases along a more evidence-based road. Integrated cardiovascular imaging is required for optimal management of the patient with suspected pericardial disease.Keywords
This publication has 50 references indexed in Scilit:
- Evaluation and management of pericarditisExpert Review of Cardiovascular Therapy, 2011
- Current Concepts in the Management of TuberculosisMayo Clinic Proceedings, 2011
- Medical therapy of pericardial diseasesJournal of Cardiovascular Medicine, 2010
- Pericardial Disease: Diagnosis and ManagementMayo Clinic Proceedings, 2010
- Diagnostic issues in the clinical management of pericarditisInternational Journal of Clinical Practice, 2010
- Treatment of Pericardial DiseaseCardiovascular Therapeutics, 2010
- Controversial Issues in the Management of Pericardial DiseasesCirculation, 2010
- Forgotten cardiovascular diseases in AfricaClinical Research in Cardiology, 2009
- Diagnosis and management of pericardial diseasesNature Reviews Cardiology, 2009
- Guidelines on the Diagnosis and Management of Pericardial Diseases Executive SummaryThe Task Force on the Diagnosis and Management of Pericardial Diseases of the European Society of CardiologyEuropean Heart Journal, 2004