Acute pericarditis
Posted by dkwinter


  • Viral or idiopathic
  • Autoimmune diseases (e.g. SLE)
  • Uremia (acute of CKD)
  • Post-myocardial infarction
    • Early: Per-infarction pericarditis (usual onset is less than 4 days following acute MI)
    • Late: Dressler syndrome (usual onset is several weeks following MI)


Clinical features & diagnosis

  • Pleuritic chest pain (that improves when sitting up)
    • usually retrosternal with radiation to bilateral shoulders
  • Pericardial friction rub (highly specific)
  • ECG: diffuse ST elevation and PR depression
    • these findings may be masked by ECG changes from recent MI
  • +/- fever (low-grade)



  • Viral and idiopathic cases
    • NSAIDs
    • Colchcine
  • Peri-infarction pericarditis (PIP)
    • High-dose aspirin (625 mg TID) for symptomatic relief (instead of NSAIDs, which may impair myocardial healing)
  • Treatment as indicated for other etiologies