Diagnosis: The electrocardiogram (EKG) strip reveals acute pericarditis, as shown by ST-elevation in leads II, III, and AVF, which is very uncommon in children. Nonsteroidal anti-inflammatory drugs can be used to treat this patient’s pain. If over-the-counter medication does not alleviate the pain, repeat EKG, chest x-ray, and/or other investigation may be necessary.
Inpatient treatment also should be considered for patients with any of the following: Fever of more than 100.4°F (38°C), immunosuppression, trauma, exposure to oral anticoagulation therapy, myopericarditis, severe pericardial effusion, and cardiac tamponade.
Case by Sudhir R. Gogu, DO, PhD, MBA, a family physician at Stone Oak Urgent Care and Family Practice in San Antonio, Texas, and Sujan Gogu, BS, a second-year medical student at Edward Via College of Osteopathic Medicine in Blacksburg, Virgina
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