PT - JOURNAL ARTICLE AU - Tevfik F Ismail TI - Acute pericarditis: Update on diagnosis and management AID - 10.7861/clinmed.cme.20.1.4 DP - 2020 Jan 01 TA - Clinical Medicine PG - 48--51 VI - 20 IP - 1 4099 - http://www.rcpjournals.org/content/20/1/48.short 4100 - http://www.rcpjournals.org/content/20/1/48.full SO - Clin Med2020 Jan 01; 20 AB - 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.