35-year-old-male presents for evaluation of chest pain. He notes that the pain is worse with deep inspiration and feels short of breath on exertion. He notes symptoms are worse with laying flat and better with leaning forward. He notes that he had a viral illness 1.5 weeks ago which has since resolved. Patient’s vitals are significant for a BP of 80/40, HR 120, temp of 100.6 F. Examination reveals patient in distress with JVD and muffled heart sounds. EKG shows diffuse ST elevations with PR depressions. This is a feared complication due to: 

A. Myocarditis

B. Pericarditis

C. Dilated Cardiomyopathy

D. Hypertrophic Obstructive Cardiomyopathy 

B. Pericarditis is identified by having 2/4 following criteria: 

• 1)  Sharp pleuritic chest pain that is worse with lying flat and improved with leaning forwarded, commonly preceded by a viral illness as the most common etiology is a virus. C
• 2)  EKG findings with diffuse ST elevation with PR depressions
• 3)  Pericardial friction rub
• 4)  New or worsening pericardial effusion

Hanson, Katy. “Pericarditis.” 31 Oct 2016. <https://hansonsanatomy.tumblr.com/post/152578048122/pericarditis>. (1-2216). 

Imazio, M et al. “Acute Pericarditis: Clinical Presentation and Diagnostic Evaluation.”  Jul 2019. <www.uptodate.com>. (10/22/19).  

Roshreview. “Acute Pericarditis.” <www.roshreview.com.> (10/22/16).