A 70-year-old woman with STEMI undergoes primary PCI at 90 minutes. On day 3, she develops fever (38.5°C), pleuritic chest pain, and a pericardial friction rub. ECG shows diffuse ST elevation. The MOST appropriate treatment is:
- A Anticoagulation with heparin infusion
- B Pericardiocentesis
- C High-dose aspirin and colchicine ✓
- D Corticosteroids
Correct answer: C. High-dose aspirin and colchicine
Explanation
Early post-MI pericarditis (Days 1–4) is treated with high-dose aspirin combined with colchicine, which is first-line for pericarditis per ESC guidelines. NSAIDs and corticosteroids are avoided in early post-MI pericarditis because they impair myocardial healing and scar formation. Pericardiocentesis is indicated for haemodynamically significant effusion, not for uncomplicated pericarditis.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.