Acute Pericarditis

Q: 54 year old male is back in Emergency Department(ED) with chest pain ten days after his discharge from hospital. He was previously admitted for Acute Myocardial Infarction (AMI). Due to EKG changes in ED, patient is admitted to ICU. Further workup confirmed acute pericarditis. Which of the following is NOT a good choice to use during management of acute pericarditis  following AMI?

A) aspirin 
B) colchicine 
C) Nonsteroidal anti-inflammatory drugs (NSAIDs)
D) Acetaminophen 
E) Proton-Pump-Inhibitors (PPI)


Answer: C

In symptomatic pericarditis after an AMI, NSAIDs should be avoided as it may impair scar formation. Recommended treatment is aspirin (ASA) with colchicine. Acetaminophen can also be used as symptomatic treatment. PPIs help to relief GI symptoms secondary to ASA and colchicine. 


Reference:

Imazio M, Cecchi E, Demichelis B, et al. Indicators of poor prognosis of acute pericarditis. Circulation 2007; 115:2739.