Heart HealthHow Pericarditis Treatment Evolved From Surgery to Targeted Biologics
Pericarditis — inflammation of the sac surrounding the heart — has been recognized since antiquity, but its treatment has transformed dramatically over the past century. This review in Circulation traces that evolution, from early surgical options like pericardiectomy to the mid-20th century introduction of NSAIDs and corticosteroids, which improved symptoms but left recurrence rates unacceptably high. Colchicine, validated in randomized trials, became a cornerstone therapy. The most significant recent advance is the recognition that recurrent pericarditis often has an autoinflammatory basis, opening the door to interleukin-1 inhibitors — anakinra and rilonacept — for refractory cases. Imaging advances, particularly cardiac MRI, now allow precise tissue characterization and risk stratification. Together, these shifts represent a move from empirical to personalized, mechanism-based care for a condition that affects heart function and quality of life across all adult age groups.
