Pericarditis III: Medical Management

The management of pericarditis involves non-pharmacologic therapy, pharmacologic therapy, and surgical treatment.

Non-pharmacologic therapy includes advising patients to sit up, lean forward, and rest, which helps relieve pain and reduces the metabolic demand on the heart.

Pharmacologic therapy involves using nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen and aspirin, as first-line treatments to relieve pain and inflammation.

Additionally, colchicine is recommended for pericarditis lasting more than ten days or recurrent pericarditis.

For patients unresponsive to NSAIDs or colchicine, alternative medications, such as corticosteroids like prednisone, are used.

If significant pericardial effusion is present, especially with signs of cardiac tamponade or heart failure, invasive procedures such as pericardiocentesis are performed to drain fluid from the pericardial sac.

In cases of constrictive pericarditis, where the pericardium becomes thickened and restricts heart function, surgical removal of the pericardium, known as pericardiectomy, may be necessary.