Therapy of symptomatic pericarditis after myocardial infarction: retrospective and prospective studies of aspirin, indomethacin, prednisone, and spontaneous resolution.

We studied the efficacy of aspirin and indomethacin therapy in relieving the discomfort of postmyocardial infarction pericarditis (PMIP) in two studies: (1) a retrospective evaluation of patients with symptomatic PMIP during a 5-year period and (2) a prospective, randomized, single-blind comparison of aspirin and indomethacin in similar patients. In the retrospective study, 36 episodes of symptomatic PMIP in 34 patients were identified; in the prospective study, 25 episodes of PMIP in 24 patients occurred. Relief from the discomfort of PMIP was noted within 48 hours in almost all patients with either indomethacin or aspirin therapy. Minor gastrointestinal bleeding developed in two patients in the retrospective study and in two patients in the prospective study. In the retrospective study, mild discomfort of PMIP abated within 48 hours in five of eight patients who received either no treatment or minor analgesic therapy. Aspirin and indomethacin are equally efficacious in relieving the discomfort of PMIP.