Non-cardiac chest pain is considered to be central chest pain that resembles angina yet, after appropriate investigation, its cause appears unrelated to the heart. The problem is common: one in four of the population have at least one episode over the course of a year and patients with chest pain account for about 5% of all presentations to primary care physicians and emergency departments.1 Ev...

OBJECTIVE To compare clinical characteristics of patients admitted with chest pain with those who had Acute Coronary Syndrome (ACS) and Non Cardiac Chest Pain (NCCP) presenting at a tertiary care center. METHODS An analytical crossectional study was done. All patients presenting to the emergency with acute chest pain of age more than 18 years who had electrocardiography done and had an initia...

Anti-leucine-rich glioma inactivated-1 (LGI1) limbic encephalitis (LE) is a rare neurological disorder that has a subacute course of progressive encephalopathy and fasciobrachial dystonic seizures. We report a patient with anti-LGI1 LE that presented with atypical manifestations that complicated the diagnosis. A 62-year-old woman presented with a chronic course of memory disturbance and a subse...

referred urgently to general hospitals. Europace 2003;5:283–291. 9. Brignole M, Menozzi C, Bartoletti A, Giada F, Lagi A, Ungar A, Ponassi I, Mussi C, Maggi R, Re G, Furlan R, Rovelli G, Ponzi P, Scivales A. A new management of syncope: prospective systematic guideline-based evaluation of patients referred urgently to general hospitals. Eur Heart J 2006;27:76–82. 10. Linzer M, Yang EH, Estes NA...

Boerhaave syndrome (BS) is a spontaneous esophageal perforation and is a life-threating but uncommon disorder. This syndrome involves a transmural perforation and typically occurs after forceful emesis. The prognosis is dependent on rapid diagnosis and correct management. The classic presentation of BS consists of vomiting, subcutaneous emphysema, and lower thoracic pain. However, significant s...

Background: Cardiac markers in serum are measured in the early hours after the onset of symptoms not to detect Acute Myocardial Infarction (AMI) but to exclude MI. To rule out AMI, one frequently must rely on the measurement of cardiac enzymes or biochemical markers when patients suspected of AMI present with atypical chest pain or a non-diagnostic ECG. We studied the levels of troponin T, and ...

Chest pain is one of the most common symptoms in psychiatric and primary care practice and a frequent reason for extensive diagnostic work-up. Despite extensive investigations no recognizable medical cause to account for these symptoms is detected in many patients with chest pain. Studies of patients with non-cardiac chest pain have revealed that many continue to report symptoms and disability ...

The diagnostic work-up of atypical chest pain frequently leads to invasive procedures. However, this painful symptomatology can sometimes be of benign origin and respond to simple therapeutic manoeuvres. A number of musculoskeletal conditions such as costovertebral joint dysfunctions should be carefully considered. We report five cases in which patient discomfort and high costs could have been ...

CLINICAL INTRODUCTION A 33-year-old man with no history of coronary artery disease presented to the rapid access cardiology clinic with an episode of atypical anginal chest pain. He had a 15 pack-year history of smoking and a family history of myocardial infarction under the age of 55. Physical examination and exercise ECG testing were unremarkable. On assessment in the cardiology clinic, blood...