In which of the following patient situations would a physician be most justified in preliminarily ruling out pericarditis as a contributing pathology to the patient's health problems?
A)
A 61-year-old man whose ECG was characterized by widespread T-wave inversions on admission but whose T waves have recently normalized
B)
A 77-year-old with diminished S3 and S4 heart tones, irregular heart rate, and a history of atrial fibrillation
C)
A 56-year-old obese man who is complaining of chest pain that is exacerbated by deep inspiration and is radiating to his neck and scapular ridge
D)
A 60-year-old woman whose admission blood work indicates elevated white cells, erythrocyte sedimentation rate, and C-reactive protein levels
Ans:
B
Feedback:
S3 and S4 irregularities and irregular heart rate are not noted symptoms of pericarditis. Widespread T-wave inversions that later normalize; chest pain radiating to the neck and scapula that is worse on inspiration; and high white cells, erythrocyte sedimentation rate, and C-reactive protein levels are all indicators of pericarditis.
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