Day 4 - Pericardial Disease

ECG Changes:

1. Widespread PR depression, ST Elevation

2. aVR - Reciprocal PR elevation, ST depression

3. Tachycardia

Medication Treatment Doses:

1. NSAID

   • Ibuprofen 600 - 800mg PO TID

   • ASA 650 - 1000mg PO TID

   • Indomethacin 25 - 50 mg PO TID

2. Colchicine

   • Loading dose 1.2mg PO x 1, then 0.6mg PO q6h x 2

   • Daily dosing of 0.6mg PO BID

3. GI Protection

   • Pantoprazole 40mg PO daily

   • For patients with hx of peptic ulcer disease, high risk for GI Bleeding, age > 65 yo

4. Prednisone

   • Higher risk of recurrence, use in setting of treatment failure with NSAIDs or significant contraindication to NSAIDs

   • Prednisone 0.2 - 0.5mg/kg/day as initial dose