Pericarditis

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Treatment

The primary treatment for pericarditis is the use of anti-inflammatory agents. Aspirin may be prescribed as initial therapy. In many cases, one of a group of agents called nonsteroidal anti-inflammatory drugs (NSAIDs) is prescribed. NSAIDs include ibuprofen (Advil®, Medipren®, Motrin®, Nuprin®, Rufen®), indomethacin (Indocin®), and naproxen (Aleve®, Anaprox®, Naprosyn®). NSAIDs are usually quite effective in reducing inflammation and eliminating the pain associated with pericarditis. The main side effects of these medications are stomach irritation and, occasionally, ulcers.

Rarely, stronger anti-inflammatory therapy is needed and steroids are prescribed. Steroid treatment lasts at least several weeks, and the dosage must be tapered (reduced slowly). Unfortunately, after some patients have completed the therapy, pericarditis returns.

If pericardial effusion is significant and there is concern that fluid is beginning to "compress" the chambers of the heart, the doctor may recommend draining the fluid. During this procedure, which is called pericardiocentisis, a thin hollow needle is carefully inserted through the chest wall into the area of accumulated fluid, and the fluid is drained through the needle. Often, a small "drain" is left in place for about a day to allow continuous fluid drainage. The fluid is usually sent to a lab for analysis, which may suggest a cause for the pericarditis.

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