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The onset of symptoms can occasionally be gradual rather than sudden. [8] The cause of pericarditis often remains unknown but is believed to be most often due to a viral infection. [4] [8] Other causes include bacterial infections such as tuberculosis, uremic pericarditis, heart attack, cancer, autoimmune disorders, and chest trauma.
This may include the neck, left or right arms, cervical spine, back, and upper abdomen. [9] Other associated symptoms with chest pain can include nausea, vomiting, dizziness, shortness of breath, anxiety, and sweating. [8] [1] The type, severity, duration, and associated symptoms of chest pain can help guide diagnosis and further treatment.
A chest x-ray is usually normal in acute pericarditis but can reveal the presence of an enlarged heart if a pericardial effusion is present and is greater than 200 mL in volume. Conversely, patients with unexplained new onset cardiomegaly should always be worked up for acute pericarditis.
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The symptoms might also come and go before you actually have a full-on heart attack. Cardiac arrest happens when the heart’s electrical system malfunctions and the heart’s pumping stops.
Pain radiates most often to the left arm, but may also radiate to the lower jaw, neck, right arm, back, and upper abdomen. [28] [29] The pain most suggestive of an acute MI, with the highest likelihood ratio, is pain radiating to the right arm and shoulder. [30] [29] Similarly, chest pain similar to a previous heart attack is also suggestive. [31]