Case Report : Acute Pericarditis Without Pericardial Rub

A 22 yrs old female medico admitted in emergency with acute and severe left sided chest pain. She was taking antipyretic drugs for the last few days. Pain was precordial, aggrevated on recumbency and does not referred to neck back or shoulder. She was sitting up on the bed and restless. Pulse was rapid and irregular, Heart sound was normal and pericardial rub was not audible. CXR was normal and serum biomarker of myocardial damage ( Trop-T ) was positive. ECG shows widespread ST segment elevation with upward concavity, T wave inversion in L1 L2 L3 without significant Q wave. On the basis of age of the patient, history ( she was taking antipyretic drugs ) clinical examination ( postural chest pain, rapid and irregular pulse ) and ECG finding ( diffuse S T and T wave changes ), the diagnosis of acute pericarditis was made and confirm by Echocardiography. She was put on aspirin, steroid and antibiotic and discharge after 15 days. Followed up every 15 days for 6 months then every month for next 6 months.