Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with pleuritic chest pain, fever, and malaise occurring [Number] weeks post-myocardial infarction. Pain is retrosternal, exacerbated by deep inspiration and supine positioning, and relieved by sitting forward. Denies recurrence of ischemic-type angina. Associated symptoms include dyspnea and non-productive cough.
Clinical Examination Findings
Cardiovascular: Pericardial friction rub noted at the left sternal border, best heard with patient leaning forward. Heart sounds distant if effusion present. Respiratory: Clear to auscultation or decreased breath sounds at bases if pleural effusion present. General: Low-grade pyrexia, tachycardia, signs of systemic inflammation.
Treatment Protocol
Initiate high-dose Aspirin (650-1000 mg TID) or NSAIDs (e.g., Ibuprofen 600 mg TID) for 1-2 weeks with gastroprotection. Colchicine (0.5 mg BID) added as adjunctive therapy to reduce recurrence risk. Corticosteroids reserved for refractory cases. Monitor inflammatory markers (CRP/ESR) and serial echocardiograms to assess for pericardial effusion or tamponade.