A patient with fever, chest pain and a rapidly changing chest X-ray

Driscoll et al. (Pediatrics 57:648, May 1976) reported a series of 43 patients with chest pain evaluated by history and physical examination, psychiatric interview, screening laboratory studies, ECG, and chest x-ray film. No organic cause was identified in 45% of patients, and various psychiatric aspects of the pain were discussed. The history obtained from pediatric patients is often suboptimal, and specific pain characteristics and associations cannot be defined. We therefore propose that more vigorous diagnostic work-ups are necessary before chest pain can be classed as "idiopathic."

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Aurea diagnosis of pneumomediastinum. A case report

Italian Journal of Medicine ◽

10.4081/itjm.2020.1292 ◽

2020 ◽

Vol 14 (3) ◽

pp. 179-183

Author(s):

Lucio Brugioni ◽

Francesca De Niederhausern ◽

Chiara Gozzi ◽

Pietro Martella ◽

Elisa Romagnoli ◽

...

Keyword(s):

Emergency Department ◽

Case Report ◽

Chest Pain ◽

Correct Diagnosis ◽

Young Male ◽

Differential Diagnoses ◽

Diagnostic Process ◽

Acute Aortic Syndrome ◽

X Ray ◽

Chest X Ray

Pericarditis and spontaneous pneumomediastinum are among the pathologies that are in differential diagnoses when a patient describes dorsal irradiated chest pain: if the patient is young, male, and long-limbed, it is necessary to exclude an acute aortic syndrome firstly. We present the case of a young man who arrived at the Emergency Department for chest pain: an echocardiogram performed an immediate diagnosis of pericarditis. However, if the patient had performed a chest X-ray, this would have enabled the observation of pneumomediastinum, allowing a correct diagnosis of pneumomediastinum and treatment. The purpose of this report is to highlight the importance of the diagnostic process.

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Pneumomediastinum and pneumopericardium in an adolescent with asthma attacks. Case report

Case reports ◽

10.15446/cr.v6n1.81485 ◽

2020 ◽

Vol 6 (1) ◽

pp. 63-69

Author(s):

María Fernanda Ochoa-Ariza ◽

Jorge Luis Trejos-Caballero ◽

Cristian Mauricio Parra-Gelves ◽

Marly Esperanza Camargo-Lozada ◽

Marlon Adrián Laguado-Nieto

Keyword(s):

Case Report ◽

Chest Pain ◽

Subcutaneous Emphysema ◽

Respiratory Symptoms ◽

Laboratory Tests ◽

Young Patients ◽

Clinical Suspicion ◽

X Ray ◽

Chest X Ray ◽

The Right

Introduction: Pneumomediastinum is defined as the presence of air in the mediastinal cavity. This is a rare disease caused by surgical procedures, trauma or spontaneous scape of air from the lungs; asthma is a frequently associated factor. It has extensive differential diagnoses due to its symptoms and clinical signs.Case presentation: A 17-year-old female patient presented with respiratory symptoms for 2 days, dyspnea, chest pain radiated to the neck and shoulders, right supraclavicular subcutaneous emphysema, wheezing in both lung fields, tachycardia and tachypnea. On admission, laboratory tests revealed leukocytosis and neutrophilia, and chest X-ray showed subcutaneous emphysema in the right supraclavicular region. Diagnosis of pneumomediastinum was confirmed through a CT scan of the chest. The patient was admitted for treatment with satisfactory evolution.Discussion: Pneumomediastinum occurs mainly in young patients with asthma, and is associated with its exacerbation. This condition can cause other complications such as pneumopericardium, as in this case. The course of the disease is usually benign and has a good prognosis.Conclusion: Because of its presentation, pneumomediastinum requires clinical suspicion to guide the diagnosis and treatment. In this context, imaging is fundamental.

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Man in his 50s with chest pain and dyspnoea

Heart ◽

10.1136/heartjnl-2017-312477 ◽

2018 ◽

Vol 104 (10) ◽

pp. 868-868 ◽

Cited By ~ 1

Author(s):

Yuki Obayashi ◽

Chisato Izumi ◽

Yoshihisa Nakagawa

Keyword(s):

Chest Pain ◽

Emergency Room ◽

Prosthetic Valve ◽

Cardiopulmonary Arrest ◽

Supplementary File ◽

List Type ◽

Main Trunk ◽

X Ray ◽

Doppler Image ◽

Chest X Ray

Clinical introductionA man in his 50s with sudden-onset chest pain and dyspnoea was transferred to the emergency room. He had a history of aortic valve replacement due to aortic regurgitation with a mechanical valve 6 years previously. Heart rate was 90 bpm, and blood pressure was too low to measure. In the emergency room, he presented with severe dyspnoea and a chest X-ray showed severe lung congestion (figure 1A). ECG showed complete left bundle branch block. His respiratory status rapidly worsened, and he went into cardiopulmonary arrest. After cardiopulmonary resuscitation, transthoracic echocardiography was performed (figure 1B, online supplementary video 1).Supplementary file 1Figure 1(A) Chest X-ray. (B) Colour Doppler image from apical five-chamber view.QuestionWhat is the most likely cause of the patient’s cardiopulmonary arrest?Myocardial infarction in left main trunkAortic dissectionProsthetic valve thrombosisProsthetic valve embolisationPulmonary embolism

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Validation of a clinical decision rule: chest X-ray in patients with chest pain and possible acute coronary syndrome

Emergency Radiology ◽

10.1007/s10140-014-1203-7 ◽

2014 ◽

Vol 21 (4) ◽

pp. 367-372 ◽

Cited By ~ 5

Author(s):

Romi Goldschlager ◽

Hedley Roth ◽

Jarryd Solomon ◽

Scott Robson ◽

Jessica Green ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Chest Pain ◽

Decision Rule ◽

Clinical Decision ◽

Clinical Decision Rule ◽

X Ray ◽

Coronary Syndrome ◽

Chest X Ray

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Idiopathic Chylopericardium in a Young Adult: Diagnosis and Management

Case Reports in Cardiology ◽

10.1155/2021/5596764 ◽

2021 ◽

Vol 2021 ◽

pp. 1-3

Author(s):

João Pedro E. Sant’Ana ◽

Amanda O. Vicente ◽

Amanda S. Pereira ◽

Pedro V. Bertozzi ◽

Rodrigo A. S. Sardenberg

Keyword(s):

Chest Pain ◽

Pleural Effusion ◽

Chest Ct ◽

Pericardial Window ◽

X Ray ◽

Large Pericardial Effusion ◽

Chest X Ray ◽

Cardiac Silhouette ◽

The Right ◽

Precipitating Factor

Primary idiopathic chylopericardium (PIC) is an uncommon cardiologic disorder; it is defined as accumulation of lymph in the pericardial sac without any know precipitating factor. A 25-year-old presented with dyspnea and chest pain for over two months. The patient underwent a chest X-ray, which revealed an enlargement of cardiac silhouette and signs of cardiac tamponade. Chest CT was performed, revealing large pericardial effusion and small pleural effusion on the right hemithorax. The patient was referred to the ICU and underwent a pericardial window through VATS, which revealed 500 ml of a milky fluid.

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Re-expansion pulmonary edema following a pneumothorax drainage in a patient with COVID-19

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01661-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Kosaku Komiya ◽

Ryosuke Hamanaka ◽

Hisayuki Shuto ◽

Hiroki Yoshikawa ◽

Atsushi Yokoyama ◽

...

Keyword(s):

Chest Pain ◽

Pulmonary Edema ◽

Left Lung ◽

Viral Pneumonia ◽

Smoking History ◽

Lung Field ◽

Rare Presentation ◽

X Ray ◽

Chest X Ray ◽

Oxygenation Status

Abstract Background Re-expansion pulmonary edema is an uncommon complication following drainage of a pneumothorax or pleural effusion. While pneumothorax is noted to complicate COVID-19 patients, no case of COVID-19 developing re-expansion pulmonary edema has been reported. Case representation A man in his early 40 s without a smoking history and underlying pulmonary diseases suddenly complained of left chest pain with dyspnea 1 day after being diagnosed with COVID-19. Chest X-ray revealed pneumothorax in the left lung field, and a chest tube was inserted into the intrathoracic space without negative pressure 9 h after the onset of chest pain, resulting in the disappearance of respiratory symptoms; however, 2 h thereafter, dyspnea recurred with lower oxygenation status. Chest X-ray revealed improvement of collapse but extensive infiltration in the expanded lung. Therefore, the patient was diagnosed with re-expansion pulmonary edema, and his dyspnea and oxygenation status gradually improved without any intervention, such as steroid administration. Abnormal lung images also gradually improved within several days. Conclusions This case highlights the rare presentation of re-expansion pulmonary edema following pneumothorax drainage in a patient with COVID-19, which recovered without requiring treatment for viral pneumonia. Differentiating re-expansion pulmonary edema from viral pneumonia is crucial to prevent unnecessary medication for COVID-19 pneumonia and pneumothorax.

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Assessment of Chest X-Ray Utilization for the Evaluation of Non-Traumatic Chest Pain in an Academic Emergency Department

International Journal of Radiology and Imaging Technology ◽

10.23937/2572-3235.1510076 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Rucker Garrett ◽

Kalayanamitra Ricci ◽

Gopaul Ravindra

Keyword(s):

Emergency Department ◽

Chest Pain ◽

X Ray ◽

Chest X Ray

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Catamenial pneumothorax due to heterotopic endometriosis in the pericardium

BMJ Case Reports ◽

10.1136/bcr-2020-240335 ◽

2021 ◽

Vol 14 (2) ◽

pp. e240335

Author(s):

Yuki Takigawa ◽

Daisuke Mizuno ◽

Norichika Iga ◽

Nobukazu Fujimoto

Keyword(s):

Chest Pain ◽

Progesterone Receptor ◽

Polyglycolic Acid ◽

Medical Examination ◽

X Ray ◽

Catamenial Pneumothorax ◽

Polyglycolic Acid Sheet ◽

Chest X Ray ◽

The Right ◽

Grade Iii

A 46-year-old woman presented with a right pneumothorax at a regular medical examination during menstruation. The pneumothorax resolved without intervention; however, 6 months later, she was referred to our hospital due to chest pain and dyspnoea. A chest X-ray showed grade III pneumothorax and surgery was performed. During surgery, the patient was found to have pleural adhesions around the right upper lung, pores in the diaphragm and a blueberry spot in the pericardium. The margins of the upper lobe and diaphragm were covered with a polyglycolic acid sheet at the operation. Eight days after surgery, she was referred to our hospital again due to massive haemothorax. The reoperation suggested that the aforementioned blueberry spot in the pericardium was the source of bleeding. The spot was resected and shown to be oestrogen and progesterone receptor-positive, providing evidence of heterotopic endometriosis.

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