Young female with chest pain

Chief Complaint A 29 y/o female presents with left sided acute chest pain. Patient took a painkiller at home but no relief. She said pain lower down on sitting. History She is hypertensive. She also had such episode of chest pain 2 months back, which relieved at its own. She drinks occasionally but never smoked. Her grandfather had surgery for coronary artery disease. Vitals BP: 125/80 mmhg, Pulse rate is 73/min, Resp rate: 18 breaths/min, Temp: 100 deg F. Investigations Chest x-ray, & Blood investigations are wnl. ECG was done which shows elevation of the ST segment like pericarditis. Treatment How the case should be managed?

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ST elevation of pericarditis is typically present in all leads and has concavity upwards If ECG is suggestive of pericarditis then it becomes first differential diagnosis of chest pain Adv 2 D Echo to look for pericarditis

Suggest observation, troponin, serial ECGs, ECHO. Investigate for comorbidities like dyslipedemia and DM Since she has temperature, xray of chest should be done . Rule out non cardiac causes like anxiety , GERD , gall bladder diseases.

Patient needs to be evaluated by 1.A Trop- T test to rule out IHD 2.2D - Echocardiography to rule out RHD Treatment depends upon the investigations report

Needs further investigation and evaluation to conclude particularly for IHD AND PERICARDITIS CONSTANT EVALUATION AND ASSESSMENT REQUIRED.

Can be proceeded wt pain relief by 1g para infusion , trop T , echo, routine hematology with lipid profile

Could be costochondritis or Infective etiology. Adv HRCT thorax and Echo CD.

POSSIBLY PERICARDITIS INFECTIVE. ORIGIN... NEEDS ECHO USG...WHOLE. ABDOMEN

Cardiac Pathology ?Pericarditis ?Aortic Aneurysm 2D Echo & Cardiac Enzymes Gastric Pathology GERD Endoscopy