TY - JOUR T1 - Acute pericarditis: Update on diagnosis and management JF - Clinical Medicine JO - Clin Med SP - 48 LP - 51 DO - 10.7861/clinmed.cme.20.1.4 VL - 20 IS - 1 AU - Tevfik F Ismail Y1 - 2020/01/01 UR - http://www.rcpjournals.org/content/20/1/48.abstract N2 - Acute pericarditis accounts for ∼5% of presentations with acute chest pain. Tuberculosis is an important cause in the developing world, however, in the UK and other developed settings, most cases are idiopathic/viral in origin. Non-steroidal anti-inflammatory drugs (NSAIDs) remain the cornerstone of treatment. At least one in four patients are at risk of recurrence. The addition of 3 months of colchicine can more than halve the risk of this (number needed to treat = four). Low-dose steroids can be helpful second-line agents for managing recurrences as adjuncts to NSAIDs and colchicine but should not be used as first-line agents. For patients failing this approach and/or dependent on corticosteroids, the interleukin-1β antagonist anakinra is a promising option, and for the few patients who are refractory to medical therapy, surgical pericardiectomy can be considered. The long-term prognosis is good with <0.5% risk of constriction for patients with idiopathic acute pericarditis. ER -