Pericarditis Quiz: Ace Your Exams

A 32-year-old woman presents to the emergency department for evaluation of midsternal chest pain. The pain started yesterday, is sharp in character, and worsens with deep inspiration. It also worsens when the patient lies down, and improves upon leaning forward. Temperature is 37.9°C (100.2°F), pulse is 66/min, blood pressure is 115/80 mmHg, and respiratory rate is 15/min, and oxygen saturation is 99% on room air. Physical examination is significant for a three-phase friction rub along the left sternal border. Electrocardiogram shows normal sinus rhythm with ST-elevations in nonconcordant leads (see image below). Echocardiogram shows trace pericardial effusion without evidence of tamponade. Which of the following is the most appropriate initial management?
 

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