What is pericarditis?
Pericarditis is inflammation of the pericardium — the thin, two-layered membrane surrounding the heart. It typically causes sharp chest pain that worsens with deep breathing or lying flat and improves with sitting up and leaning forward. Most cases are viral and resolve with anti-inflammatory medication (NSAIDs and colchicine). However, recurrent pericarditis affects 15-30% of patients, and constrictive pericarditis may require surgical pericardiectomy.
The complete answer.
Pericarditis can also occur after cardiac surgery (postpericardiotomy syndrome, affecting 10-40% of patients) or as Dressler syndrome after myocardial infarction. Pericardial effusion (fluid accumulation) can progress to cardiac tamponade — a life-threatening emergency requiring drainage. The COPE and CORP trials established colchicine as first-line therapy alongside NSAIDs, reducing recurrence from 30-50% to 15-20%. Interleukin-1 blockers (rilonacept, anakinra) are now available for refractory recurrent pericarditis.
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