Clinical Signs of Acute Pericarditis and Its Complications Bernard M. Karnath, MD, and Roxana Narat, MD Questions 1 and 2 are based on the following clinical vignette: A 53-year-old man with a past medical history of hypertension and coronary artery disease presents to the emergency department complaining of chest pain and shortness of breath that started about 1 hour ago. Four weeks ago, he was admitted to the hospital after having a myocardial infarction (MI). Cardiac enzymes, chest radiograph, and an electrocardiogram (ECG) are ordered. The ECG (above) shows the following: 1. What is the most likely diagnosis? Acute MI Early repolarization Pulmonary embolus Acute pericarditis Click here to compare your answer. 2. What medication is appropriate for treatment? Aspirin Indomethacin Ibuprofen Propranolol Click here to compare your answer. Questions 3 and 4 are based on the following clinical vignette: A 47-year-old woman with end-stage renal disease who missed her last dialysis session presents to the emergency department with left-sided chest pain and dyspnea. On physical examination, she is tachycardic and hypotensive and has jugular venous distension and a friction rub. 3. What physical examination sign should be sought to confirm the diagnosis of cardiac tamponade? Kussmaul’s sign Pulsus paradoxus Phalen’s sign Chvostek’s sign Click here to compare your answer. 4. What laboratory or diagnostic study should be ordered next? Echocardiogram Cardiac enzymes Sputum stain for mycobacterium Computed tomography Click here to compare your answer. Click here to read more about Clinical Signs of Acute Pericarditis and Its Complications (Requires Adobe Acrobat Reader) Check our archives to test your knowledge in other clinical signs: If you do not already have Acrobat Reader, simply click on the icon below, scroll down to the "Get the Free Acrobat Reader" heading and follow the instructions to install the program. Acrobat enables you to convert any document into an Adobe Portable Document Format (PDF) file for easy viewing. Download Adobe Acrobat Reader   Hospital Physician     JCOM     Seminars in Medical Practice Hospital Physician Board Review Manuals About TWC    Subscribe    Contact TWC    Home    Search   Site Map Copyright © 2009, Turner White Communications Updated 1/04/08 • kkj