Q. Explain Treatment of Acute pericarditis?

Symptomatic Treatment

Pain relief can be achieved with indomethacin 25 to 50 mg. thrice daily; Ibuprofen 600 mg. thrice daily for 1 or 2 weeks. In case of persistence of pain prednisolone 40 to 60 mg. orally for 5 days and then tapered over 3 weeks is useful.

Specific Treatment

Specific treatment is directed to the etiology of pericarditis. Ideopathic and viral pericarditis do not require additional treatment. For tuberculous pericarditis, four drugs regime is recommended for 9 months, with atleast 6 months treatment after culture conversion. For pursulent pericarditis, appropriate antibiotic against the infecting organism should be given.

Follow Up

Most of the patients of ideopathic or viral pericarditis need follow up for atleast 1 month to make certain that the pericarditis process has completely resolved. Followup also is required to exclude the development of constrictive pericarditis especially in tuberculous and perulent pericarditis.

Complications

Recurrence ==> About 20 per cent cases of pericarditis especially idiopathic, viral or Dressler's syndrome, can recur. If pericardial effusion occurs, then it needs management (see later). Recurrent pericarditis may require treatment with steroids.