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Medicina Clínica (English Edition) Holistic management of acute pericarditis: An updated clinical approach
Journal Information
Vol. 165. Issue 2.
(July 2025)
Review
Holistic management of acute pericarditis: An updated clinical approach
Abordaje integral de la pericarditis aguda: un enfoque clínico actualizado
José Rozadoa,b,
Corresponding author
joserozadocast@gmail.com

Corresponding author.
, Luis Gutiérrez de la Vargaa,b, María Martína,b
a Servicio de Cardiología, Hospital Universitario Central de Asturias, Oviedo, Spain
b Instituto de Investigación Sanitaria de Principado de Asturias, Oviedo, Spain
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Table 1. Aetiologies, subtypes and specific characteristics of acute pericarditis.
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Table 2. Differential diagnosis of acute pericarditis.
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Table 3. Drug therapies in pericarditis: dosage, duration, dose de-escalation, practical recommendations and adverse reactions.
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Abstract

Acute pericarditis is the most frequent pericardial syndrome in clinical practice. Its symptomatology, evolution and prognosis can be very diverse and are highly conditioned by its aetiology. In Western countries, the idiopathic aetiology associated with viral conditions is the most frequent, with a good prognosis under optimal medical treatment, however, other etiologies such as purulent, neoplastic or autoimmune present a worse prognosis with the need for specific treatments. Therefore, an adequate etiologic diagnosis is essential and risk stratification will also be key to detect those entities at risk of complications that require in-hospital diagnostic and therapeutic management. Individualized treatment is essential based on anti-inflammatory drugs with different therapeutic regimens depending on each aetiology and form of presentation, but without forgetting a humanized and patient-centered approach to achieve results in health and quality of life for these patients.

Keywords:
Pericarditis
Acute pericarditis
Recurrrent pericarditis
Pericarditis/diagnostic
Pericarditis/clinical presentation
Pericarditis/teraphy
Resumen

La pericarditis aguda es el síndrome pericárdico más frecuente en la practica clínica. Su sintomatología, evolución y pronostico están muy condicionados por su etiología que puede ser muy diversa. En los países occidentales la etiología idiopática asociada a cuadros virales es la más frecuente, de buen pronóstico bajo tratamiento medico optimo, sin embargo, otras etiologías como la purulenta, neoplásica o autoimune presentan un peor pronostico con necesidad de tratamientos específicos. Por ello, un adecuado diagnostico etiológico es imprescindible y además será clave una estratificación del riesgo para detectar aquellas entidades con riesgo de complicaciones que requieren de un manejo diagnostico-terapéutico hospitalario. El tratamiento individualizado es fundamental, basado en fármacos antiinflamatorios con diferentes regímenes terapéuticos en función de cada etiología y forma de presentación, pero sin olvidar un abordaje humanizado y centrado en el paciente para conseguir resultados en salud y calidad de vida de estos pacientes.

Palabras clave:
Pericarditis
Pericarditis aguda
Pericarditis recurrente
Pericarditis/abordaje diagnóstico
Pericarditis/presentación clínica
Pericarditis/abordaje terapéutico

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