In epidemiological studies the diagnosis of a past history of myocardial infarction is made from the answer to a single question: "Have you ever had a severe pain across the front of your chest lasting for half an hour or more?" Two additional questions, which form an optional part of the London School of Hygiene and Tropical Medicine chest pain questionnaire, were used in two large community s...

Introduction: Diabetic ketoacidosis (DKA) is a common diabetic complication presenting to the Emergency Department (ED). Early recognition and initial aggressive treatment of DKA decreases morbidity and mortality. Clinical presentations of DKA are non specific such as nausea, vomiting, dehydration and abdominal pain. Chest pain is unusual presentation of DKA, however, acute coronary syndrome an...

Upon arrival on scene the crew finds a middle aged overweight male sitting at a table in the cafeteria. The patient is conscious, alert and fidgeting anxiously. He is pale, diaphoretic, and his right hand is balled into a fist and is pressed against the left side of his chest. The patient complains of severe retro-sternal chest pain radiating to his left arm and jaw. The patient describes the p...

We describe an interesting case of pneumomediastinum secondary to cocaine abuse. The patient presented with severe chest pain following nasal inhalation of a large quantity of cocaine. Investigations revealed no chest injury; however oesophagitis was proven leading to a possible aetiology of oesophageal microperforation. After conservative management there was spontaneous resolution of the pneu...

Acute aortic dissection usually presents with severe chest and/or back pain but may have a varied presentation ranging from syncope, stroke, and heart failure to shock or tamponade. We present classic chest computed tomography images of a case of type A aortic dissection presenting with cardiac tamponade.

A 57-year-old male was admitted with suspected acute coronary syndrome. He reported experiencing moderate chest pain when walking during the day prior to admission, but had very prominent ST segment elevations in the precordial electrocardiography (EKG) leads. A physical examination revealed remarkable severe kyphoscoliosis with chest deformity. The patient's cardiac troponin levels remained no...

This article describes a rare clinical manifestation of arrhythmogenic cardiomyopathy in 13-year-old boy - the “hot phase”, characterized by severe chest pain and significant increase on level troponin I. The case demonstrates difficulties differential diagnosis this disease an importance integrated approach to examination patient, including cardiac magnetic resonance imaging genetic testing.

A 42-year-old woman who had a diagnosis of asthma since childhood that was refractory to corticosteroid therapy complained of chest discomfort, progressive dyspnea on exertion, and chronic cough, all gradually worsening in severity over the past several years. Her chest pain was described as a constant band-like pressure encircling the chest wall, and was exacerbated by cold weather, exertion, ...

A 58-year old woman had felt some chest pains on effort for several days. She was admitted to the emergency room with severe and refractory chest pain after exercise. Electrocardiogram showed marked ST-segment elevations in II, III, aVF and V1-6 electrodes. Echocardiogram revealed neither wall motion asynergy in the left ventricle nor abnormal pericardial effusion. Chest X-ray showed normal fin...