A long-term consequence of pericarditis

Mr RD, a 47-year-old flight attendant, presents to you with subacute exertional dyspnoea and minor bilateral leg swelling. He first noticed these symptoms around two months ago when he started becoming easily fatigued on long flights. His breathing has also been worsening when walking up stairs.

The practice nurse performs an ECG and spirometry, both of which return normal results. Considering the patient’s worrying nonspecific symptoms and the possibility of venous thromboembolism or heart failure, you refer him to hospital for further investigation and management.

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