=====Pericarditis=====
  *usually viral (esp Coxsackie) but may be other infections
  *idiopathic
  *uraemia
  *neoplastic, paraneoplastic and post Rx eg. radiotherapy
  *post MI (**Dressler's syndrome**)

**Pain**
  *typically retrosternal but may radiate to trapezius M area
  *typically pleurtic
  *typically worse supine, better upright and leaning forward

Typical ECG changes - widespread concave upwards ST elevation & PR elevation with reciprocal ST depression and PR elevation in aVR which usually normalises from around 3/52
{{ :wiki:cardiovascular:pericarditis.png?400|}}

==Management==
  *analgesia - NSAIDs, aspirin is especially good
  *colchicine - some evidence to suggest it reduces recurrence
  *steroids if contra-indications to NSAIDs
  *reduce physical exertion
  *admission if T>38 <sup>0</sup>C or other risk factors
    *immunosuppressed
    *anticoag's
    *effusion
    *trauma related
    *rise in Trop
    *worsening symptoms including failure of pain management after 1/52 (with NSAIDs, colchicine)

<WRAP round box>Exercise caution adding NSAIDs to patients already on anti-platelet or anti-coag agents. Not contraindicated, depending on cause, but all risk factors must be taken into account </WRAP>

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**References include:**\\ 
[[http://ether.stanford.edu/library/cardiac_anesthesia/Cardiology/ST-Segment%20Elevation.pdf|NEJM review of non-MI ST elevation 2003]]\\ 
https://litfl.com/pericarditis-ecg-library/\\ 
https://www.uptodate.com/contents/acute-pericarditis-treatment-and-prognosis\\ 
https://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-15/Management-of-acute-pericarditis-treatment-and-follow-up\\