A previously healthy 40 year-old female presents to the emergency department with a 1-day history of sharp, left-sided, non-radiating chest pain that worsens with lying down and a dry cough. Associated SOB. She recently traveled by air from San Diego to New York. She is up to date on her vaccines. Physical examination reveals an HR of 116 bpm, a BP of 110/70 mm Hg, an RR of 18 b/min, and Spo2 of 98% on RA. Lungs sound distant. She has a normal S1 and a split S2, and a 2/6 vibratory systolic murmur heard at the left midsternal border. Her chest pain is not reproducible with palpation over costochondral junctions. no pedal edema. A CXR is normal. An ECG is obtained (figure).
@Everyone Next best step?
Anticoagulation
NSAIDs
Nitroglycerin
Diltiazem
2
Acute pericarditis
We can give medication for pain and inflammation, such as ibuprofen or high-dose aspirin. Depending on the cause of pericarditis
If the pt have severe symptoms that last longer than two weeks, or they clear up and then return we give Colchicine or prednisone