Pericarditis in Patients with Autoimmune Disease: Insights into Prevalence and Optimal Management

Initially recognized as a key cardiac feature of systemic lupus erythematosus and rheumatoid arthritis, autoimmune pericarditis has gained increasing attention given the recent advances in cardiac imaging, biomarker assessment, and understanding of immune-mediated mechanisms. The prevalence of pericardial involvement varies considerably among autoimmune diseases. Patients may have a small pericardial effusion that remains clinically silent but could also present with acute, recurrent, or chronic pericarditis. A minority develop severe complications such as tamponade or constrictive physiology. Characterizing autoimmune pericarditis is critical, particularly in an era of expanding immunomodulatory therapies. This review summarizes current knowledge on prevalence, pathophysiology, clinical presentation, and diagnostic strategies, with a particular focus on emerging therapeutics in pericardial disease associated with autoimmune disorders. Integrating rheumatology and cardiology expertise is essential to optimize the care of this heterogeneous patient population.