This patient is a 38-year-old housewife who presented with a one-month history of difficulty, in breathing, chest pain and bilateral leg swelling and had a blood pressure of 260/150 mmHg, features of malignant hypertension and hypertensive heart disease. Chest CT scan revealed a chest location of the left kidney. She also had elevated serum urea and creatinine and proteinuria (++). The right ki...

In August 2015, a 35-year-old man presented from an outside hospital with chest pain, recurrent left lower lobe pneumonia and a pleural mass seen on chest radiograph. Physical exam revealed multiple café-au-lait spots on his face, back, chest, abdomen, and legs that ranged from 5mm to 15mm, as well as nodules present on the patient’s right flank, as seen in (Figure 1), and lateral to his left e...

An 84-year-old woman presented to our hospital with dyspnea on exertion and left back pain. Chest X-ray and chest computed tomography (CT) revealed an irregular pleural mass invading her left chest wall with rib destruction and pleural effusion. CT-guided needle biopsy revealed diffuse large B-cell lymphoma. Low-dose oral etoposide produced a complete response, and she continued oral chemothera...

Coronary subclavian steal syndrome is a rare complication of coronary artery bypass grafting surgery (CABG) when a left internal mammary artery (LIMA) graft is utilized. This syndrome is characterized by retrograde flow from the LIMA to the left subclavian artery (SA) when a proximal left SA stenosis is present. We describe a unique case of an elderly male who underwent CABG 6 years ago who pre...

A 26-year-old man, the father of two children, was admitted on May 2, 1949, complaining of pain in the chest, coughing up blood, feverishness, and shortness of breath. His illness began four weeks before this date with a pleuritic pain in the left upper chest. Three days after first experiencing this pain he coughed up the first of daily half-cupfuls of blood-stained sputum. Intermittent fever ...

(Chest 1993; 104:251-53) A 23-year-old Hispanic man was admitted for bilateral arm weakness. Two weeks earlier, he had fallen forward on an outstretched left arm and developed pain. One day after visiting a local chiropractor for manipulation ofhis upper arms and back, he noted weakness and numbness in his arms as well as bilateral shoulder pain. There was no lower extremity weakness or bowel o...

Case Presentation Present Medical History A 67-year-old white man presented to Hermann Hospital upon referral from an Austin, Tex, physician for evaluation of recurrent chest pain. Eighteen months before admission the patient first noted episodes of chest discomfort, which he described as a left parasternal sensation of heaviness or tightness variably associated with moderate physical exertion....

A 67-year-old white man presented to Hermann Hospital upon referral from an Austin, Tex, physician for evaluation of recurrent chest pain. Eighteen months before admission the patient first noted episodes of chest discomfort, which he described as a left parasternal sensation of heaviness or tightness variably associated with moderate physical exertion. The discomfort would last 3 to 4 minutes ...

A 57-year old previously healthy male presented following an episode of sudden-onset central chest tightness and syncope whilst driving. There was no prior history of such episodes. Baseline observations, physical examination, electrocardiograph and chest radiograph were all normal. Cardiac biomarkers were negative and transthoracic echocardiography revealed a structurally and functionally norm...

A 50-year-old man suffering from recurrent chest pain accompanied by transient ST-segment elevation developed spasm of the left anterior descending coronary artery after receiving ergonovine maleate. During spontaneous chest pain, thermodilution coronary sinus blood flow fell from 96 ml/min to 46 ml/min, while the coronary sinus arteriovenous oxygen difference widened from 9.82 volumes percent ...