Case 2

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A 20-year-old man presents to the ED with 1 day of sharp, central chest pain. This pain is pleuritic and is worse with lying down. He had a recent upper respiratory tract infection.

There is no past history of similar pain. He is a smoker. There is no significant family history of note.

Examination showed a low-grade temperature of 37.8 degrees C, but was otherwise unremarkable. 

The nurse shows you an ECG.