On the second hospital day after an inferior STEMI, a 57-year-old man is afebrile but complains of pleuritic chest pain that worsens when lying flat. Examination reveals a scratchy sound heard throughout systole and diastole at the left sternal border. ECG shows PR depression without recurrent ST elevation. Which treatment is most appropriate?

• A Colchicine monotherapy
• B Indomethacin for 10 days
• C Prednisone 60 mg daily
• D High-dose aspirin ✓

Explanation

Early post-infarction pericarditis occurs within days of MI, producing pleuritic positional pain and a triphasic friction rub, and is treated with high-dose aspirin. Indomethacin and corticosteroids reduce coronary perfusion, impair scar formation, and increase the risk of infarct expansion and free wall rupture, so they are avoided. Colchicine is used as adjunctive therapy in recurrent or refractory cases but is not monotherapy for the initial episode.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.