Significant improvement is expected in 1 to 2 days. Dysrhythmias and hemodynamic complications are rare. Patients should be referred to a specialist upon arrival in port, even if asymptomatic. They should rest until asymptomatic and should not return to duty until full evaluation is completed. Patients with atypical presentations, especially if ischemia, tuberculosis bacterial infection, or suspected tumor, should be expeditiously transferred to a tertiary care facility.
Hemodynamic compromise demands rapid evaluation.
Pericardiocentesis may be required. In the past, indomethacin was used, but caused more gastric irritation. Prednisone has proven effective in difficult cases, but is frequently associated with recurrence. 0.6 mg BID has been effective in treating recurrent pericarditis. The severity of illness, suspected etiology, and firmness of diagnosis dictate the disposition and urgency of disposition.