What is the role of aspirin/NSAIDs in the treatment of pericardial effusion?

Updated: Nov 28, 2018
  • Author: William J Strimel, DO, FACP; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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Answer

Most acute idiopathic or viral pericarditis occurrences are self-limited and respond to treatment with aspirin (650 mg q6h) or another NSAID. For idiopathic or viral pericarditis, ibuprofen is preferred, given its low adverse effect profile, favorable impact on the coronary blood flow, and large dose range. Based on severity and response, the dose can range from 300-800 mg every 6-8 hours. [28]

Aspirin may be the preferred nonsteroidal agent to treat pericarditis after myocardial infarction because other NSAIDs may interfere with myocardial healing. Indomethacin should be avoided in patients who may have coronary artery disease.

In a study of 196 patients at high risk for tamponade because of pericardial effusion more than 7 days after cardiac surgery, Meurin et al found that diclofenac was not effective in reducing the size of the effusion or in preventing late cardiac tamponade. In the multicenter, randomized, double-blind trial, patients received either diclofenac (50 mg) or placebo twice daily for 14 days. [29]


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