Case scenario

Amir is a 24-year-old who presents to the pharmacy asking for something to ease the pain in his chest. He describes a sharp central discomfort that began 3 days ago, shortly after a flu-like illness resolved. The pain is worse when lying down and eases when sitting upright. He also mentions mild breathlessness and intermittent palpitations, and wants ibuprofen so he can return to football training tonight.

You take a brief targeted history. The combination of pleuritic, positional chest pain with dyspnoea and palpitations after a recent viral illness raises concern for pericarditis or possible myocarditis. You do not supply ibuprofen. You explain your concerns and recommend that he see a doctor today or present to the emergency department (ED) for further investigation. Amir agrees to attend the ED.

Learning outcomes

After reading this article, pharmacists should be able to:

  • Recognise the clinical features of pericarditis and myocarditis
  • Describe the key investigations, treatment options and potential complications associated with pericarditis and myocarditis
  • Outline counselling principles for the safe use of NSAIDs and colchicine in patients with pericarditis, including relevant drug interactions
  • Outline activity restrictions following cardiac inflammation, and key counselling points following cardiac inflammation and COVID-19 vaccine-associated cardiac symptoms.

Competency standards (2016) addressed: 1.1, 1.4, 1.5, 2.2, 3.1, 3.5

Accreditation number: PSAAP2610NR

Accreditation expiry: 30/09/2028

Accreditation points: Up to 1.5 Group 2

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