Our patient's diagnosis is acute pericarditis. The physical examination confirmed the history. The positive findings include a low-grade fever and a classic 3-component pericardial friction rub heard at the lower left sternal edge. Further evaluation includes selected laboratory studies.
Blood was drawn to evaluate the complete blood count and differential, erythrocyte sedimentation rate, renal function, serum electrolytes and troponin. All were normal except for mild leukocytosis and mild elevation of the sedimentation rate. An elevated troponin level in the presence of pericarditis suggests a mild pericarditis.