In case of chest pain with pericarditis and pericardial effusion, pain is refered by?
**Core Concept**
The pain in pericarditis and pericardial effusion is referred due to irritation of the pericardium, which is a fibroserous sac surrounding the heart. This irritation leads to inflammation and activation of nociceptors, resulting in pain perception.
**Why the Correct Answer is Right**
The pain in pericarditis is typically referred to the anterior chest wall and the neck, due to the innervation of the pericardium by the phrenic nerves (C3-C5). The phrenic nerves carry sensory fibers from the pericardium to the spinal cord, where they are interpreted as pain. The pain is often described as sharp and stabbing, and can be exacerbated by deep breathing or coughing.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because the pain in pericarditis is not typically referred to the back.
**Option B:** This option is incorrect because the pain in pericarditis is not typically referred to the epigastrium.
**Option C:** This option is incorrect because the pain in pericarditis is not typically referred to the shoulder.
**Clinical Pearl / High-Yield Fact**
The pain in pericarditis can be differentiated from myocardial infarction by its sharp and stabbing nature, and its location, which is typically anterior and not radiating to the arm.
**Correct Answer:** D.