Central sharp chest pain: what is the diagnosis?

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.

Key Points

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.

Thursday 25 April 2024

Central sharp chest pain: what is the diagnosis?

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