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Pericarditis after viral illness — SCE Acute Medicine MCQ

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EasyAcute Cardiac PresentationsPericarditis after viral illnessSCE Acute Medicine

A 33-year-old man is assessed on the acute medical unit. He has sharp central chest pain improved by sitting forward after a viral illness. ECG shows widespread concave ST elevation and PR depression. Initial assessment includes relevant observations, bedside tests and urgent blood results. What is the most likely diagnosis?

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Correct answer: A — Acute pericarditis

Acute pericarditis is the best answer because pleuritic positional chest pain with diffuse ST elevation and PR depression is typical acute pericarditis. Hyperkalaemia is plausible, but it is less appropriate for the physiology or timing described in this stem. The other distractors either fit a neighbouring presentation, delay definitive treatment, or miss the key immediate risk. Clinical pearl: Regional reciprocal ST depression would be more concerning for STEMI.

Reference: ESC pericardial disease guideline