What are the recommended management strategies for a patient diagnosed with viral pericarditis?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025Updated: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Recommended management strategies for viral pericarditis focus primarily on symptom relief and preventing complications. Initial treatment involves the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen to reduce inflammation and chest pain, which is the cornerstone of therapy . Colchicine is recommended as an adjunct to NSAIDs to improve symptom resolution and reduce the risk of recurrence, typically prescribed for 3 months in acute cases . Patients should be advised to rest until symptoms improve and inflammatory markers normalize . Corticosteroids are generally reserved for cases refractory to NSAIDs and colchicine or when these are contraindicated, due to the risk of increased recurrence . Hospital admission is usually not required unless there are signs of complications such as cardiac tamponade, large pericardial effusion, or hemodynamic instability . Follow-up includes clinical assessment and echocardiography to monitor resolution and detect complications early . Antibiotics are not indicated unless bacterial infection is suspected. Overall, management is supportive and guided by symptom severity and risk of complications, with NSAIDs and colchicine forming the mainstay of treatment .

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