scholarly journals An unusual cause of ‘pleuritic’ chest pain

2008 ◽  
Vol 7 (2) ◽  
pp. 80-82
Author(s):  
Evelyn S Tan ◽  
◽  
Pierre J Willemse ◽  
Ahmed H Abdelhafiz ◽  
◽  
...  
Keyword(s):  
Chest Pain ◽  
Exercise Tolerance ◽  
Sudden Onset ◽  
Smoking History ◽  
Isosorbide Mononitrate ◽  
Past Medical History ◽  
Pleuritic Chest Pain ◽  
Intravenous Morphine ◽  
Drug History ◽  
History Of

A 77 year old man presented to A&E with sudden onset left sided chest pain. This chest pain was severe enough to wake him up from sleep in the early hours of the morning. The pain was pleuritic in nature and severe enough to require administration of intravenous morphine. He had a past medical history of ischaemic heart disease (1997), pulmonary embolism (1997), and left sided pnuemothorax (1998). Drug history consisted of lansoprazole 30mg od, isosorbide mononitrate 60mg od, nicorandil 10mg bd, aspirin 75mg od, beclomethasone 100 inhaler 1 puff bd, salbutamol 100 inhaler prn and combivent nebuliser qds. He was a retired miner, having worked for 40 years underground. There was also a 20 pack year smoking history although he had stopped for 20 years. He was independent and had a 100 to 200 yard exercise tolerance on the flat. Observations showed respiratory rate of 18, temperature of 36.5 degrees Celsius, BP 133/69, oxygen saturation of 98% on air and a regular pulse of 70 beats per minute. Clinical examination did not reveal any abnormality, with no abdominal or chest wall tenderness.

scholarly journals Atypical Euglycemic Ketoacidosis in a non-diabetic Patient due to acute pancreatitis

2021 ◽  
Vol 11 (3) ◽  
pp. 332-336
Author(s):  
Andree Emanuilov Manov ◽  
Ikechukwu Ogbu
Keyword(s):  
Acute Pancreatitis ◽  
Metabolic Acidosis ◽  
Medical History ◽  
Clinical Presentation ◽  
Sudden Onset ◽  
Low Grade ◽  
Past Medical History ◽  
Pleuritic Chest Pain ◽  
Severe Metabolic Acidosis ◽  
History Of

We describe the case of a previously healthy 40- year-old Female with a known medical history of essential hypertension (HTN). She did not have past medical history of Diabetes Mellitus. She presents to the emergency department with sudden onset of severe shortness of breath that began shortly after non-bilious, non-bloating emesis. She also reported low-grade fever, nausea, cough, abdominal pain, pleuritic chest pain, and generalized weakness. She was found to have acute pancreatitis. She was diaphoretic. She had Kussmaul breathing. She was subsequently admitted to the intensive care unit (ICU) for severe metabolic acidosis. The cause of her metabolic acidosis and clinical presentation was found to be the acute pancreatitis which very rarely can be the cause of euglycemic ketoacidosis.

scholarly journals Chest pain? Again?

CJEM ◽  
1999 ◽  
Vol 1 (01) ◽  
pp. 63
Author(s):  
Kirk Hollohan
Keyword(s):  
Chest Pain ◽  
Medical History ◽  
Sudden Onset ◽  
Smoking History ◽  
Left Shoulder ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
The Moment

A 46-year-old man presented to the ED after the sudden onset of chest pain 45 minutes earlier. He had been straining (installing a fan) when the pain began. He described the pain as a severe pressure that radiated to his left shoulder and arm. No radiation to the neck or back was noted. He denied shortness of breath, nausea, diaphoresis, syncope or palpitations. He had not previously experienced similar symptoms and felt well until the moment the pain began. Past medical history included poorly controlled hypertension for 15 years and a 35 pack-year smoking history.

scholarly journals The Forgotten Valve, Isolated Pulmonic Valve Endocarditis, a Rare Case Report

2020 ◽  
Vol 5 (5) ◽  
Keyword(s):  
Case Report ◽  
Chest Pain ◽  
Rare Case ◽  
Pulmonary Valve ◽  
Sudden Onset ◽  
Shortness Of Breath ◽  
Past Medical History ◽  
Pulmonic Valve ◽  
Rare Case Report ◽  
History Of

Of the four cardiac valves, the pulmonic valve is the least suspected in most pathologies when one thinks of endocarditis, pulmonary valve is hardly considered. We can call it a “forgotten valve”. Isolated pulmonary valve endocarditis has less than 100 reported cases [1]. We present a case of isolated pulmonary valve endocarditis in a 27-year-old male with past medical history of IVDA, who presented to the hospital with sudden onset of chest pain and shortness of breath.

A rare case of spontaneous haemothorax in patient with haemophilia A

2021 ◽  
Vol 14 (4) ◽  
pp. e242412
Author(s):  
Suthaphong Tripoppoom ◽  
Nophol Leelayuwatanakul
Keyword(s):  
Chest Pain ◽  
Rare Case ◽  
Rare Event ◽  
Haemophilia A ◽  
Minor Trauma ◽  
Conservative Approach ◽  
Pleuritic Chest Pain ◽  
Good Clinical Outcome ◽  
History Of

Haemorrhage in patients with haemophilia is common after minor trauma but may occur spontaneously. Despite the diversity of bleeding sites, spontaneous haemothorax, on a non-traumatic basis, is an exceedingly rare event and only a few cases had been reported. We present a case of a 43-year-old man with a history of haemophilia A who had pleuritic chest pain for 1 day without significant history of trauma. Diagnostic thoracentesis showed bloody pleural fluid in which neither abnormal cell nor organism was found. He was treated by cryoprecipitate replacement and therapeutic thoracentesis for releasing haemothorax. After discharge, the patient returned for follow-up with complete radiological resolution. Regarding the consequences of retained haemothorax from conservative approach and the procedure-related bleeding of given therapeutic intervention in haemothorax making its management in patients with haemophilia to be more challenging. Our case illustrates a conservative treatment of spontaneous haemothorax in patient with haemophilia resulting in a good clinical outcome.

Syncope and palpitations

2010 ◽  
pp. 2636-2642
Author(s):  
K. Rajappan ◽  
A.C. Rankin ◽  
A.D. McGavigan ◽  
S.M. Cobbe
Keyword(s):  
Heart Disease ◽  
Chest Pain ◽  
Cardiac Death ◽  
Cerebral Hypoperfusion ◽  
Loss Of Consciousness ◽  
Past Medical History ◽  
Cardiac Syncope ◽  
Appropriate Treatment ◽  
Cardiac Condition ◽  
History Of

Syncope is a transient episode of loss of consciousness (T-LOC) due to cerebral hypoperfusion. Its causes can be subdivided on the basis of pathophysiology, including (1) neurally mediated—or reflex—syncope; (2) orthostatic hypotension; (3) cardiac causes; and (4) cerebrovascular or psychogenic causes. Neurocardiogenic syncope, or simple faint, is the commonest cause and is benign, but it is always important to exclude or establish the diagnosis of cardiac syncope, because this has an adverse prognosis that may be improved with appropriate treatment. Cardiac arrhythmia should be considered in all patients who have syncope associated with any of the following: (1) exertion, chest pain, or palpitations; (2) a past medical history of heart disease; (3) abnormal cardiovascular findings on examination; (4) an abnormal ECG; and (5) a family history of sudden cardiac death in people younger than 40 years old or with an inherited cardiac condition....

scholarly journals Noncompaction and Takotsubo Syndrome in a Neuromuscular Disorder

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Josef Finsterer ◽  
Claudia Stöllberger ◽  
Walter Benedikt Winkler
Keyword(s):  
Chest Pain ◽  
Beta Blockers ◽  
Liver Cyst ◽  
Neuromuscular Disorder ◽  
Sudden Onset ◽  
Left Ventricular ◽  
Takotsubo Syndrome ◽  
Troponin Elevation ◽  
History Of ◽  
St Elevation

Background. Takotsubo syndrome (TTS) in patients with left ventricular hypertrabeculation/noncompaction (LVHT) has been reported in four patients, and a TTS plus LVHT plus a neuromuscular disorder (NMD) was only reported once so far. Here, we present the fifth patient with LVHT and TTS and the second patient with LVHT, TTS, and a NMD. Methods and Results. The patient is a 68 yo female hobby choir singer with a history of skin dermatofibroma, skin fibrokeratoma, arterial hypertension, hyperlipidemia, hypothyroidism, anemia, hyponatremia, diverticulosis, LVHT detected at age 60 y, five syncopes, a liver cyst, and carotid endarterectomy 2 months prior to admission because of sudden-onset chest pain. Workup revealed ST elevation, troponin elevation, and mild coronary artery sclerosis. Ventriculography and transthoracic echocardiography (TTE) showed the apical type of a TTS. ECG normalised within 10 w and TTE within 6 w under beta-blockers and ATII-blockers. The TTS was triggered by being offended of being unable to sing anymore after endarterectomy. Neurological workup suggested the presence of a NMD. Conclusions. This case shows that LVHT occurs in NMD patients and that patients with LVHT and a NMD may develop a TTS. Whether patients with LVHT and a NMD are particularly prone to develop a TTS requires further confirmation. NMD patients with LVHT should avoid stress not to trigger a TTS.

Case Report: Early signs of tamponade may be detected by cardiac point-of-care ultrasound

POCUS Journal ◽  
2017 ◽  
Vol 2 (3) ◽  
pp. 24-25 ◽  
Author(s):  
Michael Cenkowski, MD ◽  
Amer M. Johri, MD ◽  
Raveen Pal, MD ◽  
Jennifer Hutchison, RDCS
Keyword(s):  
Blood Pressure ◽  
End Stage Renal Disease ◽  
Point Of Care ◽  
Vital Signs ◽  
Point Of Care Ultrasound ◽  
Past Medical History ◽  
Pleuritic Chest Pain ◽  
History Of ◽  
Stage Renal Disease ◽  
End Stage

A 35-year-old male with a past medical history of end stage renal disease on hemodialysis and a chronic pericardial effusion secondary to dialysis presented to the Emergency Room (ER) with a 2-week history of a flu-like illness and pleuritic chest pain. He was compliant with dialysis three times per week. His blood pressure was 150/85 mmHg with a heart rate of 85 beats per minute and the remainder of his vital signs were stable. Pulsus paradoxus was not present.

Picture Quiz: A Case of Sudden Severe Chest Pain

2007 ◽  
Vol 6 (1) ◽  
pp. 27-27
Author(s):  
Mustafa Abu Rabia ◽  
◽  
P Sullivan ◽  
Stavros M Stivaros. ◽  
◽  
...  
Keyword(s):  
Chest Pain ◽  
Medical History ◽  
Chest Wall ◽  
Epigastric Pain ◽  
Anterior Chest Wall ◽  
Sudden Onset ◽  
Severe Chest Pain ◽  
History Of ◽  
Previous Medical History

An 18-year-old male with no previous medical history presented to hospital with sudden onset of acute epigastric pain radiating to the anterior chest wall and both shoulders. There was no history of recent trauma and he had not been vomiting.

scholarly journals Previously undiagnosed scoliosis presenting as pleuritic chest pain in the emergency department – a case series and a validating retrospective audit

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gabor Xantus ◽  
Derek Burke ◽  
Peter Kanizsai
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Chest Wall ◽  
Adult Population ◽  
Case Series ◽  
Sudden Onset ◽  
Pleuritic Chest Pain ◽  
Record System ◽  
Diverse Range ◽  
Retrospective Audit

Abstract Background Chest pain is one of the commonest presenting complaints in urgent/emergency care, with a lifelong prevalence of up to 25% in the adult population. Pleuritic chest pain is a subset of high investigation burden because of a diverse range of possible causes varying from simple musculoskeletal conditions to pulmonary embolism. Case series Among otherwise fit and healthy adult patients presenting in our emergency department with sudden onset of unilateral pleuritic chest pain, within 1 month we identified a cohort of five patients with pin-point tenderness in one specific costo-sternal joint often with referred pain to the back. All cases had apparent and, previously undiagnosed mild/moderate scoliosis. Methods To confirm and validate the observed association between scoliosis and pleuritic chest pain, a retrospective audit was designed and performed using the hospital’s electronic medical record system to reassess all consecutive adult chest pain patients. Results The Odds Ratio for having chest pain with scoliosis was 30.8 [95%CI 1.71–553.37], twenty times higher than suggested by prevalence data. Discussion In scoliosis the pathologic lateral curvature of the spine adversely affects the functional anatomy of both the spine and ribcage. In our hypothesis the chest wall asymmetry enables minor slip/subluxation of a rib either in the costo-sternal and/or costovertebral junction exerting direct pressure on the intercostal nerve causing pleuritic pain. Conclusion Thorough physical examination of the anterior and posterior chest wall is key to identify underlying scoliosis in otherwise fit patients presenting with sudden onset of pleuritic pain. Incorporating assessment for scoliosis in the low-risk chest pain protocols/tools may help reducing the length of stay in the emergency department and, facilitate speedy but safe discharge with increased patient satisfaction.

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