A patient presents with sharp, pleuritic chest pain that improves when sitting up and leaning forward. The patient also reports a recent history of a respiratory infection. Which additional clinical finding would MOST likely support the diagnosis of pericarditis?
The presence of a pericardial friction rub is a hallmark sign of pericarditis and is caused by the inflamed layers of the pericardium rubbing against one another. While ECG changes, an enlarged heart on chest x-ray, and fever might also be associated with pericarditis, the pericardial friction rub is more specifically indicative of pericarditis and therefore is the best answer. ECG changes are nonspecific and can be seen in various cardiac conditions. An enlarged heart on chest x-ray would suggest other diagnoses, such as heart failure or cardiomegaly, rather than specifically indicating pericarditis. Fever could be related to the recent respiratory infection or a variety of other conditions.
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Cardiovascular Emergencies
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