A 52-year-old man is brought to the emergency department because of worsening shortness of breath for 6 hours. For the past 5 days, he has had intermittent stabbing pain in the middle of his chest that worsens with lying down or taking deep breaths. He has also had a runny nose and a dry cough for the past 2 weeks. Other medical history is unremarkable. The patient is a lifetime nonsmoker and has no family history of early-onset heart attack, sudden death, or cardiomyopathy. Blood pressure is 120/70 mm Hg and pulse is 110/min and regular. Which of the following physical examination findings is most expected in this patient?

Question

A 52-year-old man is brought to the emergency department because of worsening shortness of breath for 6 hours. For the past 5 days, he has had intermittent stabbing pain in the middle of his chest that worsens with lying down or taking deep breaths. He has also had a runny nose and a dry cough for the past 2 weeks. Other medical history is unremarkable.  The patient is a lifetime nonsmoker and has no family history of early-onset heart attack, sudden death, or cardiomyopathy.  Blood pressure is 120/70 mm Hg and pulse is 110/min and regular.  Which of the following physical examination findings is most expected in this patient?

Quizplus · Accepted Answer

Eductional Objective: Acute-onset, sharp, and pleuritic chest pain that decreases with leaning forward is characteristic of acute pericarditis.  Fibrinous/serofibrinous pericarditis is the most common form of pericarditis and a pericardial friction rub is the most specific physical finding.  Viral pericarditis is often preceded by an upper respiratory infection.

A 52-Year-Old Man Is Brought to the Emergency Department Because