Category: Cardiac Ischemia

Pericarditis: Prehospital Treatment Options

Question#: 540

Question:

During my preceptorship, we carried an 18y/o female Pt who had received the 1st dose of her Covid vaccine on Thursday. Today was Saturday. The Pt was diagnosed with Pericarditis and was being transferred out of St. Francis to the Heart Institute. The Pt was in significant chest pain, and was contraindicated for Analgesia and ASA due to previous drug administration at the ER. My preceptor and I were discussing the possibility of giving Nitro for the pain relief, with a patch of course.

We were just wondering if this would have been an appropriate treatment?

Answer:

The pain associated with pericarditis is a result of inflammation and not a narrowing or blockage of the coronary arteries. The administration of NTG causes a decrease in preload pressure to the heart and a corresponding drop in BP. Restrictive pericarditis is dependent on venous return which can be reduced by NTG. Anti-inflammatories (if not already given) and opiates would be the drugs of choice. Certainly a consult with a BHP is always available and recommended in this situation to discuss possible treatment options.

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