A 60-year-old female patient complains of chest pain that worsens with deep breathing and coughing

A 60-year-old female patient complains of chest pain that worsens with deep breathing and coughing

A 60-year-old female patient complains of chest pain that worsens with deep breathing and coughing. Physical examination reveals a friction rub over the precordium. Which of the following conditions is the most likely diagnosis?

A. Myocardial infarction

B. Pericarditis

C. Pulmonary embolism

D. Aortic dissection

Answer: B

Explanation: Pericarditis is characterized by pleuritic chest pain (worsened by breathing/coughing) and a pericardial friction rub (a high-pitched, scratchy sound heard over the precordium). Myocardial infarction causes crushing chest pain not related to breathing (A is incorrect). Pulmonary embolism presents with sudden dyspnea and pleuritic pain but no friction rub (C is incorrect). Aortic dissection causes severe "tearing" chest pain radiating to the back (D is incorrect).