A 15-year-old young man presented to the emergency department with a 3-week history of sharp left-sided chest pain, shortness of breath on exertion, and a low-grade intermittent fever. Chest radiograph revealed increased density in the upper left lobe, thus he was treated with antibiotics for query pneumonia. Although his fever subsided, the patient continued to have chest pain, and subsequentl...

Birt-Hogg-Dubé syndrome (BHD) is a genetic disorder typically characterized by pulmonary cysts, cutaneous fibrofolliculomas, and renal tumors. We report case of an 87-year-old male patient with known diagnosis BHD large pericardial cyst who presented to the emergency room chest pain. classically associated cysts not cysts. In this report, we highlight potential independently cause retrosternal ...

Introduction: Pneumothorax is a potentially dangerous condition that, if not properly recognized and treated, can have fatal consequences. Chest discomfort or difficulty breathing common presenting symptoms. We present an atypical presentation for pneumothorax. Case Report: A 26-year-old male patient presented to the emergency department (ED) with complaints of pain in right iliac fossa localiz...

INTRODUCTION Knowledge of the characteristics of patients with atypical presentation of acute coronary syndromes may contribute to increased sensitivity in diagnosis in a given population. The purpose of this study is to quantify the prevalence of atypical presentation, to identify its determinants, and to describe the presenting symptoms in cases of acute coronary syndrome at the emergency dep...

BACKGROUND Many noninvasive tests exist to determine whether patients should undergo coronary angiography. The routine use of coronary angiography without previous noninvasive testing is typically not advocated. OBJECTIVE To determine the cost-effectiveness of diagnostic strategies for patients with chest pain. DESIGN Cost-effectiveness analysis. DATA SOURCES Published data. TARGET POPU...

The congenital absence of the left circumflex artery (LCx) is a very rare congenital anomaly of coronary arteries, but it is benign. Currently, the best modality for the diagnosis of coronary anomalies is computed tomography coronary angiography (CTCA). We report a case of congenitally absent LCx with an atypical chest pain.

A 55-year-old man presented with dyspnea on effort and atypical chest pain. Physical examination revealed a loud, continuous cardiac murmur over the left parasternal area. A coronary arteriovenous fistula draining into the right atrium was suspected at transthoracic echocardiography (Figures 1 and 2) and clearly documented by transesophageal echocardiography (Figure 3) and coronary arteriograph...

Chest pain is one of the most common presenting complaints in the emergency department, though only a small minority of patients are subsequently diagnosed with acute coronary syndrome (ACS). However, missing the diagnosis has potential for significant morbidity and mortality. ACS presentations can be atypical, and their workups are often prolonged and costly. In order to risk-stratify patients...

We present a case of Wellens' syndrome together with upright T wave in lead V(1) in a man presenting with atypical chest pain, and we discuss the significance of its prompt recognition by the emergency physicians who are involved in the evaluation of patients with coronary artery disease in emergency departments.

background athletes present a different category of the population. trivial complaints may mask more serious illness, especially when the athlete is undergoing intensive training, and the function of his immune system may be sub-optimal. case presentation a triathlete presented a few days after completing an ironman race, complaining of lethargy, pleuritic chest pain and loss of appetite. on ex...