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A Shocking Deficiency.

Patient presentation: A 48-year-old woman with a history of recurrent pericarditis presented with 3 weeks of progressive chest pain and dyspnea. Her chest pain was pleuritic, nonpositional, and similar in character to her previous episodes of pericarditis, but was atypical in that it was constant, severe in intensity, and associated with palpitations and dyspnea at rest. She denied orthopnea, paroxysmal nocturnal dyspnea, fevers, chills, or cough. She reported several days of intermittent lightheadedness without syncope.