Chest pain that is pleuritic (changes with respiration) and positional (relieved by sitting up and leaning forward).

The pain will be described as sharp and brief.

Ischemic pain is dull and sore, like being punched.

The vast majority of pericarditis cases are viral. Although any infectious agent, collagen -vascular disease, or trauma can be in the history,


Physical examination finding:

The only  positive finding is a friction rub, which can have three components. the rub is only present in 30 percent of patients.


There is no pulsus paradoxus, tenderness, edema, or Kussmaul’s sign present.

Blood pressure is normal, and there is no jugular venous distention or organomegaly.



Diagnostic Testing:

The best initial test is the ECG. ST segment elevation is present everywhere (all leads). PR segment depression is pathognomonic but is not always present.



The best initial therapy is an NSAID, such as indomethacin, naprosyn, aspirin, or ibuprofen.
If the pain persists, add prednisone orally to the treatment.

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