A 39-year-old man comes to the emergency department with anterior chest pain. He had felt well until the pain developed 4 days ago. The patient says the pain is sharp and makes it difficult to take a deep breath. Since yesterday, he has also felt out of breath. Medical history is unremarkable. The patient's father died of a heart attack at age 52, and his mother suffers from rheumatoid arthritis. He does not use alcohol or tobacco. Temperature is 37.4 C (99.3 F), blood pressure is 112/65 mm Hg, and pulse is 103/min and regular. Bedside ultrasound examination demonstrates a moderate pericardial effusion. Which of the following is the most likely cause of this patient's current condition?

Question

A 39-year-old man comes to the emergency department with anterior chest pain.  He had felt well until the pain developed 4 days ago.  The patient says the pain is sharp and makes it difficult to take a deep breath.  Since yesterday, he has also felt out of breath.  Medical history is unremarkable.  The patient's father died of a heart attack at age 52, and his mother suffers from rheumatoid arthritis.  He does not use alcohol or tobacco.  Temperature is 37.4 C (99.3 F), blood pressure is 112/65 mm Hg, and pulse is 103/min and regular.  Bedside ultrasound examination demonstrates a moderate pericardial effusion.  Which of the following is the most likely cause of this patient's current condition?

Quizplus · Accepted Answer

Eductional Objective: Viral infection is the most common cause of acute pericarditis.  It causes a fibrinous or serofibrinous pericarditis that is often characterized by pleuritic chest pain, a friction rub on cardiac auscultation, diffuse ST elevation on ECG, and mild to moderate-sized pericardial effusion.

A 39-Year-Old Man Comes to the Emergency Department with Anterior