Pericarditis aguda

Acute pericarditis is an acute inflammation of the pericardium and the most common pathology of this membrane. 80-90 % of cases of acute pericarditis are idiopathic or viral, while the remaining cases are specific etiologic forms. Its main clinical manifestations are: chest pain, pericardial friction rub and fever. For diagnosis at least 2 of the following 4 criteria should be present: characteristic chest pain; pericardial friction rub; suggestive electrocardiographic changes and new or worsening pericardial effusion. Electrocardiogram is an important diagnostic tool, and classically evolves in a sequence of four stages. Echocardiography is recommended in patients with hemodynamic compromise. Differential diagnosis with diseases that cause chest pain must be made. Acute pericarditis complications are: pericardial effusion without tamponade, cardiac tamponade, constrictive pericarditis and recurrence. Acute myopericarditis is frequent. In 70-90 % of patients, viral or idiopathic acute pericarditis has benign and self-limiting course and without serious complications. Most patients respond to treatment with nonsteroidal antiinflammatory agents. Colchicine is indicated to prevent recurrent episodes of pericarditis. Usually corticosteroids should be avoided.