Misdiagnosis of Acute Pericarditis Presenting with Coronary Artery Disease: a Case Report

Pericarditis is a common disorder that might present in various settings, including primary-care and emergency department. However, the clinical features in some cases did not match with the written theory, which could lead to a misdiagnosis. We reported a 34-year-old female presented to the emergency room with progressive tightness chest pain in the past 3 days, that got worse with a change in position and penetrated to the back. Based on clinical chest pain with history of stable coronary artery disease, no changes electrocardiograph (ECG) and normal laboratory evaluation, the patient was diagnosed with NSTE-ACS, treated based on guideline therapy but did not showed clinical improvement. Clinical re-examination and echocardiography evaluation showed a pathognomonic finding of pericarditis feature. Combination therapy of colchicine was given for 3 months and aspirin for 2 weeks. Follow-up evaluation showed normal ECG and echocardiography result without any remainder symptoms. Acute pericarditis does not always show typical clinical findings. Therefore, clinician must always aware with other differential diagnosis of chest pain and ECG variation of acute pericarditis even though the patient has a history of coronary artery disease