Differential Diagnosis for Sharp Chest Pain and Flu-like Symptoms with Pericardial Friction Rub
- Single most likely diagnosis:
- Acute Pericarditis: This is the most likely diagnosis given the presence of sharp chest pain and a pericardial friction rub, which are classic signs of pericarditis. The flu-like symptoms could be indicative of a viral etiology, which is a common cause of acute pericarditis.
- Other Likely diagnoses:
- Myocarditis: This condition can present with similar symptoms to pericarditis, including chest pain and flu-like symptoms. The presence of a friction rub is more specific to pericarditis, but myocarditis can sometimes cause a friction rub as well.
- Pulmonary Embolism (PE) with pericardial involvement: While less common, a pulmonary embolism can cause sharp chest pain and, if the embolism is large enough, can lead to pericardial involvement, potentially causing a friction rub.
- Do Not Miss diagnoses:
- Acute Coronary Syndrome (ACS): Although the presentation is not typical for ACS, it's crucial not to miss this diagnosis, as it requires immediate intervention. The presence of a friction rub does not rule out ACS, especially if there's associated myocardial infarction involving the pericardium.
- Aortic Dissection: This is a life-threatening condition that can cause sharp, tearing chest pain. While a friction rub is not a typical finding, the severity of the condition necessitates its consideration in the differential diagnosis.
- Rare diagnoses:
- Uremic Pericarditis: This condition occurs in patients with severe renal failure and can present with pericarditis symptoms, including a friction rub. It's less likely but should be considered in patients with a history of renal disease.
- Tuberculous Pericarditis: Although rare in many parts of the world, tuberculous pericarditis can present with chronic pericarditis symptoms, including a friction rub. It's an important consideration in endemic areas or in patients with a history of tuberculosis exposure.