Contemporary management of pericardial diseases

被引:59
作者
Imazio, Massimo [1 ]
机构
[1] Maria Vittoria Hosp, Dept Cardiol, I-10141 Turin, Italy
关键词
cardiac magnetic resonance; constrictive pericarditis; echocardiography; pericardial effusion; pericarditis; CONSTRICTIVE PERICARDITIS; MEDICAL THERAPY; POSTPERICARDIOTOMY-SYNDROME; RECURRENT PERICARDITIS; CARDIAC-TAMPONADE; DOUBLE-BLIND; EFFUSION; COLCHICINE; PREVENTION; DIAGNOSIS;
D O I
10.1097/HCO.0b013e3283524fbe
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of review 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. Recent findings 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. Summary 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.
引用
收藏
页码:308 / 317
页数:10
相关论文
共 57 条
[1]   Transient constrictive pericarditis: an elusive diagnosis [J].
Akyuz, Sukru ;
Yaylak, Baris ;
Ergelen, Mehmet ;
Uyarel, Huseyin .
FUTURE CARDIOLOGY, 2010, 6 (06) :785-790
[2]  
Almeida AR, 2011, REV PORT CARDIOL, V30, P433
[3]   Clinical review: Intrapericardial fibrinolysis in management of purulent pericarditis [J].
Augustin, Pascal ;
Desmard, Mathieu ;
Mordant, Pierre ;
Lasocki, Sigismond ;
Maury, Jean-Michel ;
Heming, Nicholas ;
Montravers, Philippe .
CRITICAL CARE, 2011, 15 (02)
[4]   Treatment of Pericardial Disease [J].
Azam, Salman ;
Hoit, Brian D. .
CARDIOVASCULAR THERAPEUTICS, 2011, 29 (05) :308-314
[5]   Medical treatment of pericarditis during pregnancy [J].
Brucato, Antonio ;
Imazio, Massimo ;
Curri, Silvia ;
Palmieri, Giancarlo ;
Trinchero, Rita .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2010, 144 (03) :413-414
[6]   Anti-heart and anti-intercalated disk autoantibodies: evidence for autoimmunity in idiopathic recurrent acute pericarditis [J].
Caforio, A. L. P. ;
Brucato, A. ;
Doria, A. ;
Brambilla, G. ;
Angelini, A. ;
Ghirardello, A. ;
Bottaro, S. ;
Tona, F. ;
Betterle, C. ;
Daliento, L. ;
Thiene, G. ;
Iliceto, S. .
HEART, 2010, 96 (10) :779-784
[7]   Colchicine in clinical medicine. A guide for internists [J].
Cocco, Giuseppe ;
Chu, David C. C. ;
Pandolfi, Stefano .
EUROPEAN JOURNAL OF INTERNAL MEDICINE, 2010, 21 (06) :503-508
[8]   Acute and recurring pericarditis: More colchicine, less corticosteroids [J].
Farand, Paul ;
Bonenfant, Francis ;
Belley-Cote, Emilie P. ;
Tzouannis, Nicholas .
WORLD JOURNAL OF CARDIOLOGY, 2010, 2 (12) :403-407
[9]   Cardiac Magnetic Resonance Imaging Pericardial Late Gadolinium Enhancement and Elevated Inflammatory Markers Can Predict the Reversibility of Constrictive Pericarditis After Antiinflammatory Medical Therapy A Pilot Study [J].
Feng, DaLi ;
Glockner, James ;
Kim, Kyehun ;
Martinez, Matthew ;
Syed, Imran S. ;
Araoz, Philip ;
Breen, Jerome ;
Espinosa, Raul E. ;
Sundt, Thoralf ;
Schaff, Hartzell V. ;
Oh, Jae K. .
CIRCULATION, 2011, 124 (17) :1830-1837
[10]   Colchicine poisoning: the dark side of an ancient drug [J].
Finkelstein, Yaron ;
Aks, Steven E. ;
Hutson, Janine R. ;
Juurlink, David N. ;
Nguyen, Patricia ;
Dubnov-Raz, Gal ;
Pollak, Uri ;
Koren, Gideon ;
Bentur, Yedidia .
CLINICAL TOXICOLOGY, 2010, 48 (05) :407-414