skip to main content

Acute Pericarditis — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

EasyCardiologyAcute PericarditisRACP Adult Medicine

A 48-year-old man presents with chest pain that worsens on inspiration and improves when leaning forward. ECG shows widespread concave ST elevation and PR depression in multiple leads. Troponin is mildly elevated. What is the most appropriate treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Pericardiocentesis

Acute pericarditis is treated with NSAIDs (ibuprofen or aspirin) plus colchicine as first-line therapy. Ibuprofen 400–800 mg TDS (or aspirin 750–1000 mg TDS) combined with colchicine 500 mcg BD (or 500 mcg daily if <70 kg) for 3 months reduces recurrence by ~50% (COPE trial). Corticosteroids are second-line as they increase recurrence risk. Mild troponin elevation (myopericarditis) does not change management unless significant myocardial involvement is suspected.

Reference: eTG – 2025 – Cardiovascular; ESC – 2015 – Pericardial Diseases Guidelines