The Daily PANCE and PANRE Extended Edition: Question 6

A 24-year-old male presents complaining of chest pain. He states that it is worse with swallowing and taking a deep breath. It is improved sitting up and leaning forward. He denies trauma, a cough, and shortness of breath. Which of the following test would be most compatible with your suspected diagnosis?

  1. a hiatal hernia visualized on chest x-ray
  2. a normal erythrocyte sedimentation rate
  3. calcified “popcorn” lesions in the lung fields bilaterally
  4. diffuse ST-segment elevation on his electrocardiograph
  5. a widened Aa gradient on his arterial blood gas

Answer: D

Diffuse ST-segment elevation on his electrocardiograph

This is pericarditis (by clinical presentation) which causes diffuse ST segment elevation on ECG (there can be notching of the R wave as well)

Know Your Content Blueprint

Pericarditis is covered as part of the PANCE Cardiology Blueprint

Review Topic: Acute pericarditis (ReelDx)