This Journal feature begins with a case vignette highlightinga common clinical problem. Evidence supporting various strategiesis then presented, followed by a review of formal guidelines,when they exist. The article ends with the authors' clinicalrecommendations.
A 35-year-old woman who is otherwise healthy has had constantretrosternal chest pain for two days. The pain becomes worsewhen she lies down and improves when she sits up and leans forward.On physical examination, the patient is afebrile and has a frictionrub. The 12-lead electrocardiogram shows widespread ST-segmentelevation and concomitant PR-segment depression. How shouldthe patient be evaluated . . . [Full Text of this Article]
The Clinical Problem
Strategies and Evidence
Causes
Evaluation
History
Physical Examination
Electrocardiography
Chest Radiography
Serologic and Other Testing
Echocardiography
Pericardiocentesis and Biopsy
Treatment
Hospitalization
Guidelines
Areas of Uncertainty
Conclusions and Recommendations
Source Information
From the Department of Internal Medicine, Cardiology Division, Johns Hopkins Medical Institutions, Baltimore (R.A.L.); and the University of Texas Southwestern Medical Center, Dallas (L.D.H.).
Address reprint requests to Dr. Hillis at Rm. G5.232, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-9030, or at dhilli@parknet.pmh.org.
Related Letters:
Acute Pericarditis
Levy P.-Y., Khan M., Raoult D., MacAlpin R., Mumoli N., Mancini A., Cei M., Lange R. A., Hillis L. D.
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N Engl J Med 2005;
352:1154-1155, Mar 17, 2005.
Correspondence
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