Acute Pericarditis — EECC MCQ

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EasyPericardial DiseaseAcute PericarditisEECC

A 35-year-old man presents with sharp pleuritic chest pain worsened by lying flat and improved by sitting forward. ECG shows widespread concave ST-segment elevation with PR segment depression. CRP is 85 mg/L. Troponin is normal. What is the recommended first-line treatment?

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Correct answer: D — Ibuprofen plus colchicine

Explanation lettering: C = shown as A · E = shown as B · A = shown as C · B = shown as D · D = shown as E

Per the 2025 ESC Myocarditis and Pericarditis Guidelines, first-line treatment for acute pericarditis is aspirin or NSAID (e.g. ibuprofen 600 mg three times daily) PLUS colchicine for 3 months. The combination reduces recurrence (COPE, ICAP trials). Colchicine alone (A) is insufficient. Ibuprofen alone (D) treats the episode but colchicine prevents recurrence. Corticosteroids (C) are second-line and associated with higher recurrence. Pericardiocentesis (E) is for tamponade or large effusions.

Reference: ESC (2025): Guidelines for the Management of Myocarditis and Pericarditis