Based on the history and ECG results, a series of questions are answered about the diagnosis of a woman with central sharp chest pain radiating into her neck.
- Patients with pericarditis may or may not have a viral prodrome. The most common viral symptoms are adenoviral – sore throat, headache and gastrointestinal tract symptoms.
- The nature of the pain is often useful in the diagnosis, especially if it is better leaning forward.
- The severe pain can resolve with analgesia very quickly, but the ECG changes can persist.
- Recurrence is possible but uncommon and more often seen in connective tissue disease.
- There may be an effusion on echocardiogram and it can be large.
- Effusion is uncommon and if it is significant it may need drainage. Pericardial constriction can occur late, so this should be kept in mind
- It is not uncommon to find a mildly elevated troponin level, probably due to some associated mild myocarditis.
- These patients usually do not have LV impairment, although it can occur.