What are the 2015 ESC guidelines for the treatment of post-cardiac injury syndromes?

Updated: Apr 02, 2019
  • Author: Sean Spangler, MD; Chief Editor: Terrence X O'Brien, MD, MS, FACC  more...
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The 2015 ESC updated guidelines have the following recommendations for patients with PCIS [3] :

  • Administer anti-inflammatory therapy to speed up symptomatic remission and reduce recurrences (class I, level B evidence).
  • Aspirin is first line for anti-inflammatory therapy of post-myocardial infarction (MI) pericarditis, as well as for individuals receiving antiplatelet therapy (class I, level C evidence).
  • Consider adding colchicine to aspirin/NSAIDs to treat PCIS, as for treating acute pericarditis (class IIa, level B evidence).
  • To prevent postpericardiotomy syndrome, consider administering post-cardiac surgery colchicine using weight-adjusted doses (ie, ≤70 kg: 0.5 mg once daily; >70 kg: 0.5 mg twice daily) and without a loading dose, for 1 month, providing there are no contraindications and it is tolerated (class IIa, level A evidence).
  • Consider careful echocardiographic follow-up every 6-12 months after PCIS to exclude potential development of constrictive pericarditis, based on the patient's clinical features and symptoms (class IIa, level C evidence).

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