A 39-Year-Old Man Comes to the Emergency Department with Anterior

A 39-year-old man comes to the emergency department with anterior chest pain.  He had felt well until the pain developed 4 days ago.  The patient says the pain is sharp and makes it difficult to take a deep breath.  Since yesterday, he has also felt out of breath.  Medical history is unremarkable.  The patient's father died of a heart attack at age 52, and his mother suffers from rheumatoid arthritis.  He does not use alcohol or tobacco.  Temperature is 37.4 C (99.3 F) , blood pressure is 112/65 mm Hg, and pulse is 103/min and regular.  Bedside ultrasound examination demonstrates a moderate pericardial effusion.  Which of the following is the most likely cause of this patient's current condition?

A) Autoimmune disease
B) Coronary artery disease
C) Gram-positive cocci
D) Malignancy
E) Viral infection

Correct Answer:

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