Szymanski, Theodore

The differential diagnoses for patients presenting with chest discomfort after endoscopy remain broad. In addition to infectious, traumatic and bleeding complications, intrinsic cardiac pathology should be considered. Though rare, pericarditis and pericardial tamponade are additional entities that the clinician should consider when evaluating these patients. We present a 74-year-old man who arrived to the emergency department with substernal chest discomfort that began shortly after upper and lower endoscopy the previous day. Biopsies were obtained during the procedure (ileal and colonic mucosa) without complication. The patient reported worsening chest discomfort with deep inspiration or lying flat. ECG was significant for diffuse ST-segment elevation and PR depression. Cardiac workup was otherwise negative; the patient improved with conservative measures. In this case report, we describe a little known complication after upper endoscopy. By highlighting the clinical features of pericarditis in this setting, the provider can be alert to recognise and promptly treat this clinical entity.