PURPOSE OF REVIEW: Pericarditis can be a chronic and complex disease requiring years of treatment. These patients require close monitoring of labs, medications and their side effects, as well as virtual and inpatient follow up. Due to the complexity of this disease, many of these patients are treated for months and sometimes years. Our review highlights the role Advanced practice providers (APP) play in managing the complexity of these patients by providing efficient and quality care. RECENT FINDINGS: Multi-modality cardiac imaging is the cornerstone to the evaluation and treatment of pericardial diseases. The addition of Interleukin (IL-1) blockers or biologics (Rilonacept, Anakinra) in the last few years provides targeted therapy for these patients. Using imaging guided therapy (IGT) these complex patients require close, continuous follow up and monitoring as well as frequent medication titration. The outcomes for these pericardial patients are improved with these centers due to the specialized medical and surgical care. Advanced Practice Providers play a vital role in a pericardial center with ordering the appropriate imaging and labs, handling medication titration, and providing patient education and continuity of care for these patients. They have been shown to decrease mortality, increase quality of care, and increase medication adherence.