A 32-Year-Old Man Comes to the Emergency Department with Chest

A 32-year-old man comes to the emergency department with chest pain that started earlier in the day.  The pain is midline and sharp and increases with deep breaths but decreases when the patient leans forward.  He had a mild respiratory illness a week ago.  Other medical history is unremarkable.  The patient is a lifetime nonsmoker and has no family history of early-onset heart attack, sudden death, or cardiomyopathy.  Blood pressure is 120/70 mm Hg and pulse is 110/min and regular.  Which of the following physical examination findings is most expected in this patient?

A) Friction rub
B) Kussmaul sign
C) Pericardial knock
D) Pulsus paradoxus
E) S3

Correct Answer:

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