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Under the topic of pericarditis it is mentioned that prednisone should be used if NSAIDS do not work in case of viral etiology, however, under the topic of myocarditis treatment it is mentioned that steroids can be damaging in pericarditis. Isn't that misprint because these two are in contrast to each other?:notsure:
 

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When you don't know the cause of pericarditis or if it is uncorrectable such as uremia then you use NSAIDs and if they don't work (relieve the pain) you go for steroids to decrease the inflammatory response.
 

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When you don't know the cause of pericarditis or if it is uncorrectable such as uremia then you use NSAIDs and if they don't work (relieve the pain) you go for steroids to decrease the inflammatory response.
In uremic pericarditis ... i think we do dialysis .... cause uremic pericarditis is one of the indication of dialysis .....
Matter of thinking about steroid ... Pericarditis if progress causes diastolic dysfunction from effusion but no damage to cardiac muscle fibre and myocarditis causes systolic dysfunction due to damage of muscle from infection ...
 

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Still

In uremic pericarditis ... i think we do dialysis .... cause uremic pericarditis is one of the indication of dialysis .....
Matter of thinking about steroid ... Pericarditis if progress causes diastolic dysfunction from effusion but no damage to cardiac muscle fibre and myocarditis causes systolic dysfunction due to damage of muscle from infection ...
Yeah but still even with dialysis some patients still have pericarditis pain and it would be wise to start them on analgesia (though not NSAIDs as they have renal failure)
 

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Do not give steroids in Acute Viral Pericarditis

Giving steroids in acute VIRAL pericarditis increases the chances of development of chronic relapsing pericarditis, which is highly debilitating. So give high does of NSAIDS for acute viral pericarditis initially
 

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Steroid shift the balance towards TH2 immune response

I think this may be the reason. Viral pericarditis mostly caused by coxsackie and echo viruses. Excessive exercise, stress and steroid treatment may shift the balance to TH2/TH1 predoninance that would weaken the immune attack and contribute to the persistence of virus.
 
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