Management

The basis of management is treatment of any underlying disorder.

Other features include:

• analgesia with NSAIDs, for example indomethacin or ibuprofen
• addition of 3 months of colchicine can more than halve the risk of recurrence (number needed to treat = four) (1)
• low-dose steroids can be helpful second-line agents for managing recurrences as adjuncts to NSAIDs and colchicine but should not be used as first-line agents (1)
• large pericardial effusions complicated by hypotension should be aspirated under ECG and echocardiographic monitoring and cardiac surgical backup
• aspiration of a pericardial effusion may also be required for diagnostic purposes

Reference:

• Ismail TF. Acute pericarditis: Update on diagnosis and management. Clin Med (Lond). 2020 Jan;20(1):48-51.