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Pericarditis Management in Individuals Contemplating Pregnancy, Currently Pregnant, or Breastfeeding

  • Pericardial Disease (AL Klein and CL Jellis, Section Editors)
  • Published:
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Abstract

Purpose of Review

Pericarditis complicates pregnancy planning, pregnancy, or the postpartum period, and the management approach requires special considerations. Here, we aim to summarize the latest research, diagnostic, and treatment strategies.

Recent Findings

Physiologic cardiovascular (CV) adaptations occurring during pregnancy complicate diagnosis, but for most patients, an electrocardiogram (ECG) and transthoracic echocardiogram (TTE) are sufficient to diagnosis pericarditis in the appropriate clinical context. Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) can be used until 20 weeks gestation as needed. The use of colchicine is encouraged at any time point to reduce the risk of recurrence. Glucocorticoids may be used at the lowest possible dose for the least amount of time throughout pregnancy and breastfeeding. For incessant, recurrent, or refractory pericarditis, or when the above therapies are contraindicated, there may be a consideration of the use of IL-1 inhibition during pregnancy, recognizing the limited data in pregnant patients. Finally, we encourage the use of a multidisciplinary team approach including OB-GYN, cardiology, and rheumatology when available.

Summary

The diagnosis and treatment of pericarditis in female patients of reproductive age require special considerations. Although highly effective treatment options are available, there is a need for greater data and larger international registries to improve treatment recommendations.

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Funding

BW is supported in part by NIH NHLBI K23HL159276-02, American Heart Association 21CDA851511.

Author information

Authors and Affiliations

  1. Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA

    Katherine Pryor & Laura Tarter

  2. Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Boston, MA, USA

    Katherine Economy

  3. Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA

    Michael C. Honigberg

  4. Boston Children’s Hospital, Boston, MA, USA

    Anne Marie Valente

  5. Division of Cardiology, Department of Medicine, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, USA

    Anne Marie Valente & Brittany Weber

  6. Leon H. Charney Division of Cardiology, Department of Medicine, New York University Langone Health, NYU Grossman School of Medicine, New York, NY, 10016, USA

    Michael Garshick

  7. Ronald O. Perelman Department of Dermatology, New York University Langone Health, NYU Grossman School of Medicine, New York, NY, 10016, USA

    Michael Garshick

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Correspondence to Brittany Weber.

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Conflict of Interest

MSG reports consultant fees from Abbvie and Horizon Therapeutics. BW reports scientific advisory board fees from Kinisika, Horizon Therapeutics (no longer active), and Novonordisk. MG reports scientific advisory board fees from Kinisika. MCH reports research grants paid to the institution from Genentech, U.S. NHLBI, and American Heart Association; consulting fees from CRISPR Therapeutics (no longer active); equity from Miga Health. AMV reports royalties from UpToDate (Editor and Peer Review); consulting fees from the Journal of the American College of Cardiology (Editorial Board); honoraria for visiting professor lecture from Rutgers University, Vanderbilt Medical Center, Westchester Medical Center, Columbia University, Cedars-Sinai Medical Center; and Advisory Board for Practice Update. The other authors declare that they have no conflict of interest.

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Pryor, K., Tarter, L., Economy, K. et al. Pericarditis Management in Individuals Contemplating Pregnancy, Currently Pregnant, or Breastfeeding. Curr Cardiol Rep 25, 1103–1111 (2023). https://doi.org/10.1007/s11886-023-01930-6

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