A 34-year-old woman is evaluated in the emergency department due to 1-day of chest and left shoulder pain. The patient describes the pain as constant and worse in certain positions. A month ago, she was treated for a skin rash and joint pain. Her medical history is otherwise unremarkable. She is a lifetime nonsmoker and does not use alcohol or illicit drugs. Her father has hypertension and had a stroke at age 64. Temperature is 37.5 C (99.5 F), blood pressure is 122/70 mm Hg, and pulse is 97/min and regular. A triphasic, scratchy sound is heard over the left sternal border with the patient sitting up. The lungs are clear on auscultation. ECG shows sinus rhythm with ST-segment elevation in all leads except avR and V1. Which of the following is the most likely diagnosis?

Question

A 34-year-old woman is evaluated in the emergency department due to 1-day of chest and left shoulder pain.  The patient describes the pain as constant and worse in certain positions.  A month ago, she was treated for a skin rash and joint pain.  Her medical history is otherwise unremarkable.  She is a lifetime nonsmoker and does not use alcohol or illicit drugs.  Her father has hypertension and had a stroke at age 64.  Temperature is 37.5 C (99.5 F), blood pressure is 122/70 mm Hg, and pulse is 97/min and regular.  A triphasic, scratchy sound is heard over the left sternal border with the patient sitting up.  The lungs are clear on auscultation.  ECG shows sinus rhythm with ST-segment elevation in all leads except avR and V1.  Which of the following is the most likely diagnosis?

Quizplus · Accepted Answer

Eductional Objective: Fibrinous pericarditis is the most common type of pericarditis and is characterized by pericardial inflammation with a serous, fibrin-containing exudate in the pericardial space.  Pleuritic chest pain and a triphasic friction rub are frequently seen.  Common causes include viral infection, myocardial infarction, uremia, and rheumatologic disease (eg, systemic lupus erythematosus, rheumatoid arthritis).

A 34-Year-Old Woman Is Evaluated in the Emergency Department Due