We report the first case of pericarditis exacerbation due to influenza B viral infection while emphasizing the importance of cardiac magnetic resonance (CMR) for the timely diagnosis and ruling out of non-effusive pericarditis in a patient with compatible, unexplained chest pain. The patient presented with left-sided chest pain that was partially relieved by leaning backward and noted persistent fatigue for several days. Pericardial friction rub, electrocardiogram (ECG), and echocardiogram abnormalities were not detected. After discharge on the morning following admission, fatigue and fever several minutes after physical exertion continued. The patient contracted influenza type B, leading to pneumonia and a second hospitalization, during which echocardiography showed moderate pericardial effusion. We conclude that the patient had pericarditis on the first admission because other compatible causes of chest pain were ruled out, symptoms were compatible with non-effusive pericarditis and could not be ruled out since CMR was not done, and the patient tested positive during his second admission for multiple known etiologic agents of pericarditis. We highlight the importance of CMR in screening patients presenting with chest pain of unknown origin to facilitate early detection and intervention.
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