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Acute Pericarditis

Also known as: pericarditis · pericardial inflammation

Inflammation of the pericardium — sharp, pleuritic chest pain that eases sitting forward, a pericardial friction rub, and widespread saddle-shaped ST elevation with PR depression. Usually viral/idiopathic and self-limiting; the danger is tamponade.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Often young adults after a viral illness; also post-MI (Dressler), uraemia, tuberculosis (important in India), autoimmune disease, malignancy and post-cardiac surgery.

Red flags — escalate / refer

Cardiac tamponade — hypotension, muffled heart sounds and raised JVP; also high fever, a large effusion, trauma or immunosuppression → admit and investigate.

Work-up / diagnosis

1ECG (diffuse ST elevation and PR depression), echocardiography (effusion/tamponade) and inflammatory markers; troponin if myopericarditis is suspected.
2Look for a cause — especially tuberculosis, uraemia and autoimmune disease — as this changes treatment.

Management — overview

Treat the underlying cause; for viral/idiopathic pericarditis the mainstay is an anti-inflammatory (NSAID) PLUS colchicine, which reduces recurrence.
Restrict strenuous exercise until resolved.
Tuberculous pericarditis needs anti-TB therapy per the national programme; drain a tamponade urgently (pericardiocentesis).

In-depthFull dosing & advanced protocol

Drug dosing

NSAID (e.g., ibuprofen) + colchicine

Viral / idiopathic pericarditis

Adult dose: Anti-inflammatory course tapered on response, with colchicine to prevent recurrence — per protocol
Route: Oral

Caution: NSAID caution in renal impairment/peptic ulcer; colchicine needs dose-reduction in renal/hepatic impairment.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

Diagnosis, causes and recurrence

Two of: typical pleuritic pain, friction rub, characteristic ECG changes, and a new/worsening effusion support the diagnosis.
Colchicine added to an NSAID improves symptoms and reduces recurrence.
Always consider tuberculosis and uraemia in the right setting; tamponade is a clinical emergency.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

Acute Coronary Syndrome (incl. STEMI)Acute myocardial ischaemia — STEMI, NSTEMI or unstable angina. STEMI needs immediate reperfusion: “time is muscle”.Acute Heart FailureRapid onset or worsening of heart-failure symptoms — breathlessness, orthopnoea and oedema, often with pulmonary congestion. Relieve congestion and find the trigger.Hypertensive EmergencySevere blood-pressure elevation (usually >180/120 mmHg) WITH acute target-organ damage (brain, heart, kidney, retina). Needs controlled IV lowering — distinct from asymptomatic severe hypertension ('urgency').

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👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

NSAID (e.g., ibuprofen) + colchicine

📈 Diagnosis, causes and recurrence

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

NSAID (e.g., ibuprofen) + colchicine

📈 Diagnosis, causes and recurrence

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Diagnosis, causes and recurrence

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Diagnosis, causes and recurrence

References