Acute pericarditis — MCCQE Part 1 MCQ

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ModerateChest PainAcute pericarditisMCCQE Part 1

A 29-year-old man has sharp central chest pain after a viral illness, worse supine and improved sitting forward; ECG shows diffuse concave ST elevation and PR depression. Which of the following is the most likely diagnosis?

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Correct answer: A — Acute pericarditis

Acute pericarditis is the single best answer because the age, timing, examination findings and investigations in the vignette fit Acute pericarditis better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to CCS pericardial disease guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: CCS pericardial disease guidance