Answer 30

30.  Choice C is the correct answer.  This patient has diffuse ST elevation and symptoms consistent with pericarditis.  This patient should be evaluated by cardiology but does not need to go straight to the cath lab.  The patients symptoms do point to GERD being in the differential, but the patient has diffuse ST elevation that you would not have with GERD.  Starting the patient on Vancomycin is not indicated right now.  The majority of case of pericarditis are viral.   Other less frequent causes are fungal, TB, post surgical, myxedema, drug induced, uremia, radiation, bacterial causes, and neoplasm.