Which of the following would be considered a clinical manifestation of acute pericarditis? Select all that apply
A) Sharp, abrupt onset of chest pain that radiates to the neck
B) Pericardial friction rub
C) Narrowed pulse pressure
D) Muffled heart sounds
E) Abnormal ECG results
Ans: A, B, E
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The manifestations of acute pericarditis include a triad of chest pain, an auscultatory pericardial friction rub, and electrocardiographic (ECG) changes. The pain usually is sharp and abrupt in onset, occurring in the precordial area, and may radiate to the neck, back, abdomen, or side. Pain in the scapular area may result from irritation of the phrenic nerve. The pain typically is pleuritic (aggravated by inspiration and coughing) and positional (decreases with sitting and leaning forward) because of changes in venous return and cardiac filling. A pericardial friction rub results from the rubbing and friction between the inflamed pericardial surfaces. Persons with cardiac tamponade usually have heart sounds that become muffled because of the insulating effects of the pericardial fluid and reduced cardiac function. A key diagnostic finding in cardiac tamponade is pulsus paradoxus or an exaggeration of the normal variation in the systolic blood pressure.
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