Background continued:

• Mr. Harrison's pain on this occasion is due to acute viral pericarditis.
• Since he has already experienced angina pectoris you will have the unique opportunity to audit the history from a patient who has, in fact, experienced both types of chest pain.
• In a recent series of 260 patients (in the USA) which employed advanced techniques to identify the etiology of acute pericarditis, neoplasm was the most common cause, 35%, followed by "autoreactive" (immune-mediated), 23%, and viral, 21%.
• The causes of pericarditis depend to a large extent on where you live. In China or Nigeria the commonest causes of pericarditis would be entirely different from the USA.