Question

A 40-year-old man presents with sharp central chest pain worse on inspiration and when lying flat, and improved by sitting forward. ECG shows diffuse concave ST elevation and PR depression. Troponin is normal and echocardiogram shows no effusion. What is the most appropriate initial management?

Accepted Answer

Start high-dose NSAID and advise avoidance of strenuous exercise until symptom resolution

Answer

Start long-term oral prednisolone

Answer

Start warfarin to reduce thromboembolic risk

Answer

Advise reassurance only with no medications

Answer

Arrange urgent pericardial window

Practice question

A 40-year-old man presents with sharp central chest pain worse on inspiration and when lying flat, and improved by sitting forward. ECG shows diffuse concave ST elevation and PR depression. Troponin is normal and echocardiogram shows no effusion. What is the most appropriate initial management?