Six days after being discharged from the hospital for treatment of acute pericarditis, a 49-year-old man came to our clinic for a follow-up appointment. The patient still had midsternal chest discomfort and dyspnea. He also reported new epigastric abdominal pain, which had begun 2 days earlier. The patient’s wife indicated that he’d had a low-grade fever since discharge, but the patient denied any chills, hematemesis, melanotic stools, diarrhea, or constipation. The patient’s medical history was significant for gastroesophageal reflux, hyperlipidemia, osteoarthritis, sleep apnea, and obesity. Along with newly prescribed indomethacin for the pericarditis (50 mg tid), he was also taking simvastatin. In addition, he occasionally took ibuprofen (800 mg/d) for osteoarthritis of his knee.
WHAT IS YOUR DIAGNOSIS?
HOW WOULD YOU TREAT THIS PATIENT?