Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with acute, sharp, pleuritic chest pain, typically retrosternal, radiating to the trapezius ridge, improved by sitting up and leaning forward. Associated symptoms include dyspnea, palpitations, and low-grade fever. Recent history of viral prodrome (URI or GI symptoms) noted. No evidence of myocardial infarction or pulmonary embolism.
Clinical Examination Findings
Cardiovascular: Pericardial friction rub noted on auscultation (best heard at the left sternal border with patient leaning forward). Tachycardia present. Heart sounds distant if effusion is present. Respiratory: Clear to auscultation, no crackles. Extremities: No peripheral edema or signs of DVT. Vitals: Stable, febrile or afebrile.
Treatment Protocol
Initiate high-dose NSAIDs (e.g., Ibuprofen 600-800mg TID) with gastroprotection (PPI). Add Colchicine (0.5mg BID) for 3 months to reduce recurrence risk. Activity restriction: Avoid competitive sports for 3-6 months until resolution of inflammation markers and normalization of ECG/Echocardiogram. Monitor for signs of cardiac tamponade.