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Riddle: A patient complains of chest pain when breathing. What is the diagnosis?

Riddle: A patient complains of chest pain when breathing.  What is the diagnosis?
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Cardiac ultrasound shows a small pericardial effusion, which, combined with the clinical picture, laboratory changes, and history of recent viral infection, reinforces the diagnosis of acute myocarditis.

Pericarditis is an inflammation of the pericardium, a thin membrane covering the heart.

The characteristic clinical picture is chest pain dependent on ventilation, which improves with forward flexion of the trunk (salat). There may be an associated fever.

A positive troponin may also occur and represent muscle cell involvement, defining the condition of myocarditis.

Physical examination may demonstrate the presence of pericardial tamponade. There are many causes of pericarditis (autoimmune, neoplastic, bacterial…) and the most common are viral and idiopathic.

The most common ECG changes are: diffuse ST-segment elevation, sinus tachycardia and diffuse PR-segment depression.

An echocardiogram usually shows a pericardial effusion.

Bibliographic references:

  • Acute pericarditis: clinical presentation and diagnosis. Massimo Imasio, et al. Updated, November 2023

Emily Brontë

Emily Brontë is a journalist and feature writer specialising in culture, entertainment, literature, and current affairs. She is dedicated to producing clear, accurate reporting that helps readers stay informed about developments in the UK and around the world.

Emily Brontë

Emily Brontë

Emily Brontë is a journalist and feature writer specialising in culture, entertainment, literature, and current affairs. She is dedicated to producing clear, accurate reporting that helps readers stay informed about developments in the UK and around the world.

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