CASE HISTORY A 13-yr-old Caucasian female was referred to the Dept of Paediatric Diseases (Havana, Cuba) with shortness of breath and pleuritic chest pain located in her right hemithorax. The pain had occurred the day before while doing physical activity and lasted ,1 h. The patient reported a 2-month history of recurrent episodes of pleuritic chest pain, which were either self-limited or relie...

Posterior sternoclavicular dislocation (PSCD) is uncommon but may cause severe mediastinal injury. We report the case of a patient with PSCD and symptomatic tracheal compression requiring surgical intervention. This was a 16-year-old male with direct chest injury presenting with pain in the right shoulder and cough forty-eight hours after the event. On physical examination, deformity of the ste...

Aortic dissection is very rare in obstetrics, but it is a fatal disease. A 37-weeks primigravida woman with dyspnea and pitting edema presented to our emergency room. The patient was diagnosed with preeclampsia and underwent an emergency cesarean section under spinal anesthesia. The patient complained of severe dyspnea after the cesarean section, and the chest computed tomography scan was done....

Transhiatal herniation of the pancreas is rare. Acute pancreatitis secondary to this phenomenon is particularly unusual. A 102-year-old woman presented with 1 day of severe chest pain, vomiting, dyspnea, and diaphoresis. Serum lipase was elevated, and computed tomography angiogram of the chest and magnetic resonance cholangiopancreatography revealed a hiatal hernia containing the pancreas, with...

A 28-year-old man with a history of inflammatory bowel disease (IBD) developed sudden-onset chest pain and dyspnea 9 days after esophagogastroduodenoscopy and colonoscopy. A chest radiograph demonstrated pneumomediastinum tracking along the left heart border. The spontaneous pneumomediastinum was presumed to be a complication of his severe colitis. The severity of our patient's symptoms ultimat...

A 55-year-old male on long-term amiodarone therapy presented with ischaemic chest pain and recurrent unwitnessed syncope. Interrogation of his internal cardiac defibrillator, which had been inserted 4 years earlier, revealed two episodes of ventricular fibrillation, the timing of which corresponded to his syncopal events. Severe spontaneous coronary artery vasospasm was observed on coronary ang...

introduction: acute coronary syndrome accounts for more than 15% of the chest pains. recently, hess et al. developed north american chest pain rule (nacpr) to identify very low-risk patients who can be safely discharged from emergency department (ed). the present study aimed to validate this rule in eds of two academic hospitals. methods: a prospective diagnostic accuracy study was conducted on...

Myocardial infarction occurring in young people with angiographically normal coronary arteries is well described but the pathophysiology of this condition remains unknown. Coronary artery spasm in association with thrombus formation and minimal atheromatous disease or spontaneous coronary artery dissection are possible causes. Two young men presented with severe chest pain after acute alcohol i...

Spontaneous rupture of the esophagus (Boerhaave syndrome) is a rare but life-threatening condition that was first described by a famous Dutch physician, Herman Boerhaave, in 1724.1 Boerhaave syndrome nearly always results from an abrupt rise in the intraluminal esophageal pressure. Vomiting, chest pain, dyspnea, and subcutaneous emphysema are the most commonly reported symptoms. The barogenic n...