27th July 2020

Mrs Smith is a 78-year-old lady who attends the emergency department with chest pain

Mrs Smith is a 78-year-old lady who attends the emergency department with chest pain on inspiration which is worse when lays down in bed. She has no shortness of breath. She has a significant cardiovascular history, and recently suffered from a myocardial infarction 5 weeks ago. On auscultation of the praecordium, a pericardial rub is heard. Observations include a temperature of 37.8oC. Initial blood tests reveal normal cardiac enzyme levels however it is noted that the Erythrocyte Sedimentation Rate is raised. 

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.