Case Study: What is causing this 30-year-old's chest pain?
A PREVIOUSLY healthy 30-year-old man presents with a 24-hour history of left-sided pleuritic chest pain.
The pain is relieved almost completely by sitting forward and is exacerbated by lying flat.
On physical examination he is mildly tachycardic, with a heart rate of 100 beats per minute.
His jugular venous pressure is normal, he is normotensive, and he has a low-grade temperature.
Blood tests taken show a mild elevation of the C-reactive protein, and leukocytosis is identified.
His viral serology returns normal.
An ECG is taken and is shown below (Figure 1).