Question
A 67-year-old man presents with an anterior myocardial infarction (MI) and receives thrombolytic therapy. Three days later, he develops chest pain that is exacerbated by lying down, and his physical findings are normal except for a friction rub. His ECG shows evolving changes from the anterior infarction but new PR-segment depression and 1-mm ST-segment elevation in all the limb leads. Which of the following is the most likely diagnosis?
| A. |
reinfarction |
| B. |
pulmonary embolism |
| C. |
viral infection |
| D. |
post-MI pericarditis |
Show Answer
|
Correct Answer � D Explanation |
 |
Ans. (D)
Pericarditis secondary to transmural infarction is very common and most cases appear within 4 days. The most common manifestation of pericarditis is a friction rub along the left sternal border. It is evanescent, lasting only a few days. The pain is usually perceived by the patient to be different than that of the infarct. It is worsened by inspiration, swallowing, coughing, or lying down. It frequently is associated with a low-grade fever.