Scenario: A 25-year-old Hispanic male arrived at the emergency room of a small community hospital with chest pain radiating into his jaw. He had been having intermittent episodes of chest pain for 2 days, but the pain became constant and more intense, which led him to seek medical attention. He had no significant medical history, denied smoking, drinking alcohol, or illicit drug use. His father died at the age of 42 from a myocardial infarction (MI). Six days earlier he had eaten some pork that he felt gave him food poisoning leading to diarrhea, nausea, and vomiting for 3 days.
Respiratory sinus arrhythmia at approximately 80 beats/min and diffuse ST-segment elevation suggestive of acute pericarditis secondary to food poisoning.
Sinus arrhythmia is a normal variant caused by breathing and is frequently seen in young healthy individuals. However, because of the patient’s symptoms and the ST elevation seen on the initial...