Which symptom is most consistent with acute pericarditis?

• A. Chest pain that is non-pleuritic
• B. Sharp pleuritic chest pain aggravated by inspiration
• C. Pain that improves with rest
• D. Absence of friction rub on auscultation

Answer: (B)

Acute pericarditis classically causes sharp, stabbing chest pain that is pleuritic—worse with deep inspiration and often worsened when lying flat, with many patients finding relief by sitting up and leaning forward. This description matches the symptom of sharp pleuritic chest pain aggravated by inspiration most closely. Other statements are less typical: pain that is non-pleuritic points away from pericarditis and toward ischemia; pain that improves with rest is not specific to pericarditis; a friction rub may be present but isn’t required for the diagnosis, and its absence doesn’t rule it out.