September 2019 Br J Cardiol 2019;26:119 doi:10.5837/bjc.2019.031
Nicolas Buttinger, Mark Forde, Timothy Williams, Sally Curtis, James Cockburn
Case A 35-year-old man, with no past medical history, self-presented to the emergency department at 20:00 with sharp central chest pain across his sternum, worse on inspiration. This was associated with a temperature of 39.1°C and sweating, and had been preceded by a two-day history of viral head-cold symptoms. He had no history of foreign travel, headache, photophobia, or features suggestive of meningism. On examination he looked pale, but was comfortable and alert with a heart rate of 84 beats per minute and a blood pressure of 115/75 mmHg. Routine blood tests showed C-reactive protein (CRP) 39 mg/L, white blood cell count (WBC) 15.9 × 10
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