Pleuritic chest pain in a 58-year-old man

摘要

A 58-year-old man with pleuritic chest pain presented for evaluation. He had a remote history of gastric surgery. There was a pericardial friction rub identified. A 12-lead ECG was consistent with acute pericarditis. Further imaging including a chest X-ray and CT scan of the chest was performed and a diagnosis was achieved. A 58-year-old man was seen in the emergency department for evaluation of 2 days of central pleuritic chest pain, worse when supine. He described a 2-week history of non-productive cough, fever and progressive generalised malaise. His past medical history was significant for gastric cancer treated surgically with an oesophagectomy and partial gastrectomy with a left hemicolonic pull through and gastrocolonic anastomosis 16 years earlier. There was no adjuvant radiation or chemotherapy and no other relevant medical history. The patient was taking no medications.