Pericarditis Quiz: Ace Your Exams

A 55-year-old man presents to the emergency department for evaluation of pleuritic chest pain that started last night. Four months ago, the patient had similar chest pain and was diagnosed with acute pericarditis. The patient responded well to colchicine and ibuprofen. He had a recurrence of symptoms 1 month ago that was treated again with ibuprofen and colchicine. The ibuprofen was able to be tapered. The patient currently only takes colchicine and has not had chest pain for the past month. Temperature is 38.0°C (100.4°F), pulse is 96/min, respiratory rate is 14/min, and blood pressure is 115/80 mmHg with a systolic pressure drop of 10 mmHg during inspiration. On cardiac auscultation there is a friction rub at the left sternal border. ECG shows normal sinus rhythm with diffuse ST-elevations. Bedside point-of-care ultrasound shows trace pericardial effusion without tamponade physiology. The patient is restarted on ibuprofen in combination with colchicine however he continues to be symptomatic. CRP is checked and is elevated. Which of the following is the best next step in the management of this patient?