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Acute pericarditis — RCPSC EM MCQ

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ModerateCardiovascular emergenciesAcute pericarditisRCPSC EM

A 41-year-old woman has chest pain that improves sitting forward after a viral illness. ECG shows diffuse concave ST elevation and PR depression. Troponin is mildly elevated, blood pressure is 118/72 mmHg and bedside echo shows no effusion. What is the most appropriate next step?

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Correct answer: E — Treat with NSAID plus colchicine if no contraindication and arrange follow-up with return precautions

Acute pericarditis has pleuritic positional pain, diffuse ST elevation and PR depression. Low-risk patients without tamponade or large effusion are treated with anti-inflammatory therapy and follow-up; myocarditis features require closer assessment.

Reference: Canadian Cardiovascular Society pericardial disease principles; Rosen's Emergency Medicine