Correct!
3. CT pulmonary angiography shows a nodule abutting the pleura in the left lower lobe
Axial enhanced CT pulmonary angiography shows no evidence of acute or chronic pulmonary embolism. There are no features of fibrotic or cystic lung disease and no evidence of alveolitis is present. No pleural effusion is seen. A noncalcified medial left base nodule closely associated with pleural surfaces is present.
Following exclusion of thromboembolic disease, cardiology was consulted for the elevated troponin, which continued to rise at 0.124 to 0.221 ng/mL (normal, ≤0.01 ng/mL). Echocardiography was performed which showed persevered left ventricular function and no regional wall motion abnormalities. However, ECG showed ST segment depression in the inferior-lateral leads, and inflammatory markers, including a high sensitivity C-reactive protein and erythrocyte sedimentation rate, were elevated at 39.1 mg/mL (normal, 0.2 mg/mL) and 49 mm/hr (normal, 0-29 mm/hr), respectively. These features, in addition to the quality of chest pain, raised the possibility of myocarditis.
Which of the following represents an appropriate step for the evaluation of this patient? (Click on the correct answer to be directed to the 5th of 17 pages)