Patients with uncomplicated<unk>  can generally be treated and followed up in an outpatient clinic. However, those with high risk factors for developing complications (see above) will need to be admitted to an inpatient service, most likely an ICU setting. High risk patients include the following: * subacute onset * high fever (> 100.4 F/38 C) and leukocytosis * development of cardiac tamponade * large pericardial effusion (echo-free space > 20 mm) resistant to NSAID treatment * immunocompromised * history of oral anticoagulation therapy *<unk>  trauma * failure to respond to seven days of NSAID treatment Pericardiocentesis is a procedure whereby the fluid in a pericardial effusion is removed through a needle. It is performed under the following conditions: * presence of moderate or severe cardiac tamponade * diagnostic purpose for suspected purulent, tuberculosis, or neoplastic pericarditis * persistent symptomatic pericardial effusion NSAIDs in viral or idiopathic pericarditis. In patients with underlying causes other than viral, the specific etiology should be treated. With idiopathic or viral pericarditis, NSAID is the mainstay treatment. Goal of therapy is to reduce pain and inflammation. The course of the disease may not be affected. The preferred NSAID is ibuprofen because of rare side effects, better effect on coronary flow, and larger dose range. Depending on severity, dosing is between 300–800 mg every 6–8 hours for days or weeks as needed. An alternative protocol is aspirin 800 mg every 6–8 hours. Dose tapering of NSAIDs may be needed. In pericarditis following<unk>  myocardial infarction, NSAIDs other than aspirin should be avoided since they can impair scar formation. As with all NSAID use, GI protection should be engaged. Failure to respond to NSAIDs within one week (indicated by persistence of fever, worsening of condition, new pericardial effusion, or continuing chest pain) likely indicates that a cause other than viral or idiopathic is in process. Colchicine, which has been essential to treat recurrent pericarditis, has been supported for routine use in<unk>  by recent prospective studies. Colchicine can be given 0.6 mg twice a day (0.6 mg daily for patients <70 kg) for 3 months following an<unk>  attack. It should be considered in all patients with<unk> , preferably in combination with a short-course of NSAIDs. For patients with a first episode of<unk>  idiopathic or viral pericarditis, they should be treated with an NSAID plus colchicine 1–2 mg on first day followed by 0.5 daily or twice daily for three months. It should be avoided or used with caution in patients with severe chronic kidney disease, hepatobiliary dysfunction, blood dyscrasias, and gastrointestinal motility disorders. Corticosteroids are usually used in those cases that are clearly refractory to NSAIDs and colchicine and a specific cause has not been found. Systemic corticosteroids are usually reserved for those with autoimmune disease.
Acute pericarditis
Myocardial stunning
Wooden chest syndrome
Uremic pericarditis
Acute coronary syndrome
Acute chest syndrome
Constrictive pericarditis
Unstable angina