[Not Available].

A young man with acute chest pain was ultimately suspected of having primary adrenal insufficiency (Addison's disease) after initially being assumed to have pericarditis.

• He presented with acute chest pain, nausea and vomiting, along with progressive lethargy, an episode of syncope and orthostatic hypotension.
• A dermatologist had recently noted hyperpigmentation.
• After admission his chest pain worsened and the ECG showed global ST elevations.
• Pericarditis was assumed and colchicine treatment was started.

Laboratory and clinical findings pointed to adrenal insufficiency rather than a purely cardiac cause.

• Tests revealed hyponatraemia, hyperkalaemia and fever.
• Cardiac troponins were normal.
• Coronary angiography showed no signs of occlusion.
• Based on his medical history and clinical findings, primary adrenal insufficiency was suspected.

The patient was treated successfully for adrenal insufficiency and recovered rapidly.

• The abstract reports 'He was treated successfully, with rapid recovery.'
• Specific treatment details beyond colchicine are not given in the abstract.

Autoimmune primary adrenal insufficiency is described as a rare cause of pericarditis that can be potentially fatal.

• The authors state 'to our knowledge' it is a rare cause of pericarditis.
• They conclude that early investigation and treatment are crucial.
• This is a single case report, so no incidence or comparative data are provided.

The patient's history included COVID-19 infection and vaccination, which were noted as part of the clinical background.

• He had COVID-19 during the pandemic and had been vaccinated.
• The abstract does not state that these were established as causes of the pericarditis.