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Patient handout

Pericarditis (acute / recurrent / IMPS)

PRODUCTION

1. Your condition

This handout is for pericarditis (acute / recurrent / imps). Your care team identified this based on: pleuritic / positional chest pain (acc/aha 2022).

Other reasons your team may use this plan: pericardial friction rub on auscultation (acc/aha 2022); ecg: diffuse st elevation + pr depression (acc/aha 2022); pericardial effusion on echo (acc/aha 2022).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

MedicationStarting doseHowWhenWhat it does
ibuprofen600–800 mg PO TID with foodPOTIDTapered: 600 TID × 1–2 wk → 400 TID × 1 wk → 200 TID × 1 wk (ACC/AHA 2022)
aspirin750–1000 mg PO q8h with PPIPOq8hPreferred in post-MI; tapered 1000 TID × 1–2 wk → 500 TID (ACC/AHA 2022)
colchicine0.5 mg BID (0.5 mg daily if <70 kg or eGFR <60)POBIDCOPE / ICAP — Class IA, reduces recurrence; ×3 mo
pantoprazole40 mgPOonce dailyGI protection during NSAID course (ACC/AHA 2022)

Plan: Pericarditis — NSAID + colchicine + tapered IL-1 escalation (2025 ESC IMPS)

3. When to call your provider

Contact your care team if any of the following happen:

  • Tamponade physiology → ED (ACC/AHA 2022)
  • Recurrence on max therapy → IL-1 blockade (ACC/AHA 2022)
  • Constrictive features → pericardiectomy referral (ACC/AHA 2022)
  • High fever >38 + WBC + bacterial features → admit for purulent / TB workup (ACC/AHA 2022)

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

  • Beck triad / pulsus paradoxus / hemodynamic compromise with effusion (ACC/AHA 2022)(life-threatening)
  • Pericarditis + troponin rise (ACC/AHA 2022)
  • Fever + pericardial fluid neutrophilic / AFB + / culture + (ACC/AHA 2022)
  • Persistent symptoms + pericardial thickening on CMR + RH cath consistent with constriction (ACC/AHA 2022)

5. Follow-up

Recurrence prevention; cardiology referral for recurrent or constrictive evaluation (ACC/AHA 2022)

6. Sources

Guideline: 2025 ESC Myocarditis/Pericarditis Guideline (IMPS) + 2025 ACC Expert Consensus

  1. pubmed.ncbi.nlm.nih.gov/16186437
  2. pubmed.ncbi.nlm.nih.gov/23992557
  3. pubmed.ncbi.nlm.nih.gov/21873705