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Creola bodies (CrBs) are clusters of columnar ciliated hyperplastic cells often observed in sputum of patients with bronchial asthma. They are suggestive of bronchial injury. +
The chest pain of angina is of sudden onset, often described as "squeezing", with a dull heavy pressure, and sometimes with radiation to left jaw, neck and arm and lasts for 2-10 minutes. +
Viral pericarditis is commonly caused by different virus such as: Coxsackie B, Echovirus, HIV or Adenovirus. It typically presents as an acute pericarditis with unspecific symptoms
It is important to consider the timeline of the chest pain occurring after the MI, which is 6 weeks in this case. The history of this patient is consistent with Dressler's syndrome. +
Corticosteroids are not the treatment of choice in Dressler's syndrome. Glucocorticoids and nonsteroidal antiinflammatory drugs are potentially harmful for treatment of pericarditis after STEMI. +
Pulsus bisferiens is a sign where on palpation of the pulse, a double peak in the aortic waveform is observed with each cardiac cycle. This finding is seen in hypertrophic cardiomyopathy. +
Constrictive pericarditis is caused by calcification and fibrosis of the pericardium, which prevents the filling of the right heart. Signs of right heart failure include: JVD, Kussmal sign, a knock heard in diastole, ascites, edema and hepato-splenomegaly. A CXR shows calcification of the pericardium. The best initial test is a CXR. CT and MRI are more accurate. Echocardiogram is used to exclude other causes of right heart failure, the myocardium moves normally in constrictive pericarditis. It is treated with diuretics and surgery. +
Echocardiogram is not the best initial test in a person suspected of having pericarditis or acute coronary syndrome. +
Although universal ST segment elevation is commonly seen in acute pericarditis, it is not a specific finding. +
The history of this patient is more consistent with Dressler's syndrome. There is nothing else in the patient history to suggest a different form of pericarditis. +
Pulsus bisferiens is a sign where on palpation of the pulse, a double peak in the aortic waveform is observed with each cardiac cycle. This finding is seen in hypertrophic cardiomyopathy. +
Echocardiogram is not the best initial test in a person suspected of having pericarditis or acute coronary syndrome. +
Although universal ST segment elevation is commonly seen in acute pericarditis, it is not a pathognomonic finding. +
''Streptococcus pneumoniae'' is the most common cause of community acquired pneumonia (~50% of cases). It presents in older or immunocompromised individuals and is more acute and severe than this patient's presentation. +