I am a 49 year old, white, female. I had heart ablation surgery for afib and suffered a cardiac tamponade and emergency pericardiocentesis. I also have mitral value prolapse with mild regurgitation. This has resulted in my 10th flare of pericarditis. First, ibuprofen was administered for several months. 2nd-Prednisone for almost a year. Every time we finished the taper, reoccurrence would happen. Then, reoccurrence would commence upon a level of 5-10mg. I have been having breakthrough chest pain on 17.5mg now. Colchicine has also been tried and failed. Now I am on my third dose of methotrexate along with prednisone. The Dr. is trying to overlap the prednisone until the methotrexate kicks in. Tachycardia persists and is relieved with Metoprolol 50mg 2 x day. I have palpitations and skipped beats. I'm very tired, fatigued. I have not been able to work since September of last year. CT Scan shows evidence that my pericardium is thickened but I am not constrictive at this point. If I came to Cleveland Clinic, would you keep me on the methotrexate and/or what would be the next course of treatment for my condition. I am told that it is very rare.
This discussion is related to REcurrent Pericarditis