Cases reported "Chest Pain"

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1/581. Dissecting intramural haematoma of the oesophagus.

    The largest series of patients (n = 10) with dissecting intramural haematoma of the oesophagus is described. The typical features, chest pain with odynophagia or dysphagia and minor haematemesis are usually present but not always elicited at presentation. If elicited, these symptoms should suggest the diagnosis and avoid mistaken attribution to a cardiac origin for the pain. precipitating factors such as a forced Valsalva manoeuvre cannot be identified in at least half the cases. Early endoscopy is safe, and confirms the diagnosis when an haematoma within the oesophageal wall or the later appearances of a longitudinal ulcer are seen. Dissecting intramural haematoma of the oesophagus has an excellent prognosis when managed conservatively. ( info)

2/581. Importance of posterior chest leads in patients with suspected myocardial infarction, but nondiagnostic, routine 12-lead electrocardiogram.

    Criteria for reperfusion therapy in acute myocardial infarction require the presence of ST elevation in 2 contiguous leads. However, many patients with myocardial infarction do not show these changes on a routine 12-lead electrocardiogram and hence are denied reperfusion therapy. Posterior chest leads (V7 to V9) were recorded in 58 patients with clinically suspected myocardial infarction, but nondiagnostic routine electrocardiogram. ST elevation >0.1 mV or Q waves in > or =2 posterior chest leads were considered to be diagnostic of posterior myocardial infarction. Eighteen patients had these changes of posterior myocardial infarction. All 18 patients were confirmed to have myocardial infarction by creatine phosphokinase criteria or cardiac catheterization. Of the 17 patients who had cardiac catheterization, 16 had left circumflex as the culprit vessel. We conclude that posterior chest leads should be routinely recorded in patients with suspected myocardial infarction and nondiagnostic, routine electrocardiogram. This simple bedside technique may help proper treatment of some of these patients now classified as having unstable angina or non-Q-wave myocardial infarction. ( info)

3/581. Sudden unexpected death from pulmonary thromboembolism--examination of antemortem chest X-ray.

    An autopsy case of a woman who died suddenly from undiagnosed and untreated pulmonary thromboembolism (PTE) on her way home from the hospital is described in this report. She had complained of chest pain and dyspnea on exertion when she visited the hospital and a chest X-ray taken at that time showed remarkable manifestation of right heart failure and PTE, compared with former x-rays taken during previous visits to the hospital. In this report we present the findings of four chest x-rays of this patient, which had been taken both before and after the development of PTE. ( info)

4/581. Treatment of a large congenital coronary fistula with coil embolization.

    A 77-year-old woman suffering from progressive dyspnea and chest pain for 2 1/2 years was admitted to hospital. There were no ECG changes at exercise test and a dobutamine stress echocardiography was normal. At catheterization, right-sided pressures were within normal limits. coronary angiography revealed a congenital coronary fistula, 3-4 mm in diameter, from the left anterior descending artery to the proximal pulmonary artery. There was no significant rise in blood oxygen saturation in the pulmonary artery. Transcatheter coil embolization was performed in the distal part of the tortuous fistula. Flow ceased within minutes, demonstrating the feasibility and efficacy of this technique for treating large fistulas. ( info)

5/581. Differential diagnosis of chest pain: a case report.

    chest pain in a common presenting complaint in many healthcare settings, including Gl settings. It may be caused by a variety of cardiac and noncardiac abnormalities. nurses can play a critical role in the differential diagnosis of chest pain by obtaining a thorough history and conducting a directed physical examination. This article describes the differential diagnosis of chest pain through a case presentation. ( info)

6/581. Traumatic aortic rupture: delayed presentation with a normal chest radiograph.

    Traumatic aortic injury is a potentially fatal complication of blunt trauma. patients with this entity may have a constellation of signs and symptoms and frequently have other significant injuries. The diagnosis is often suspected through abnormalities on the presenting chest radiograph. Delay in diagnosis results in increased morbidity and mortality. This report details the delayed presentation of an ambulatory patient with traumatic aortic rupture and a normal chest radiograph. ( info)

7/581. Blunt trauma-induced bilateral chylothorax.

    This report describes the case of a man who presented in a delayed manner after blunt trauma with bilateral chylothoraces, a rare result of trauma. He presented with shortness of breath and chest pain. A diagnostic workup resulted in the determination of traumatic chylothorax. His course in the hospital identified a disruption at a level of the 5th thoracic vertebra. No surgical ligation was required because his leak spontaneously sealed after conservative measures. The anatomy, physiology, mechanisms, and management of this injury are discussed. ( info)

8/581. Anterior chest wall pain in postpartum costochondritis.

    Costochondritis is a common diagnosis in patients with anterior chest wall pain in whom serious disease has been excluded. The diagnosis is usually made on clinical grounds, because laboratory and imaging investigations usually provide little information. The authors describe a young woman with postpartum costochondritis and discuss the role of bone scintigraphy in confirming the clinical diagnosis. ( info)

9/581. Postanginal septicaemia with external jugular venous thrombosis: case report.

    Postanginal septicaemia is a syndrome of anaerobic septicaemia, septic thrombophlebitis of the internal jugular vein, and metastatic infections, that follows a localized infection in the area drained by the large cervical veins. The syndrome was well-known and often fatal in the preantibiotic era. It is now rather rare, presumably as a result of the almost routine use of prophylactic antibiotics. The symptoms are classic, and it should be suspected in any case where septicaemia and metastatic lesions are preceded by a head and neck infection. We report a case that is typical, except that branches of the external jugular vein were thrombosed. To our knowledge this has not been reported previously. ( info)

10/581. Spontaneous pneumomediastinum in an 18-year-old black Sudanese high school student.

    Spontaneous pneumomediastinum (SPM) is defined as pneumomediastinum in the absence of an underlying lung disease. It is the second most common cause of chest pain in young, healthy individuals (< 30 years) necessitating hospital visits. It is surpassed in frequency in this setting only by spontaneous pneumothorax. These two conditions may coexist in 18% of patients. The incidence of spontaneous pneumomediastinum varies in different communities and generally is relatively uncommon. Inhalational drug use (cocaine and cannabis) have been associated with a significant number of cases, although cases with no apparent etiologic or incriminating factors are well recognized. Also its recurrence, though uncommon, is worthy of note. It is a benign clinical condition with diverse clinical presentations. physicians' knowledge of the presentation, treatment, and prognosis of SPM will guard against the need for expensive radiologic and laboratory tests. The differential diagnosis of chest pain, shortness of breath, and dysphagia include cardiac, pulmonary, and esophageal diseases. The tendency to pursue these entities may lead to laboratory investigations such as electrocardiograms, arterial blood gases, ventilation/perfusion scans, and contrast radiographic studies of the esophagus. ( info)
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