Chest pain has been reported as a cardinal clinical feature among the patients with acute coronary syndrome (ACS). However, several patients exhibit the atypical or no symptom on initial evaluation. Atypical symptom was defined as the absence of chest pain before or during admission, and may have included gastrointestinal or respiratory symptoms such as dyspnea, nausea, vomiting, and abdominal ...

BACKGROUND Lack of chest pain or atypical pain does not exclude acute coronary syndrome (ACS). AIM To assess demographic and clinical characteristic as well as treatment strategies in patients with atypical chest pain on admission in hospitals without on-site invasive facility (IF). METHODS Twenty-nine community hospitals participated in the Registry of Acute Coronary Syndromes. A total of ...

BACKGROUND There is speculation that women and South Asian people are more likely than men and white people to report atypical angina and that they are less likely to undergo invasive management of angina. We sought to determine whether atypical symptoms of angina pectoris in women and South Asians impacted clinically important outcomes and clinical management. METHODS We prospectively identi...

Chest pain is common, and tends to be overinvestigated. Patients with normal coronary anatomy have a low mortality, but remain significantly incapacitated. We discuss ways of improving the management of such patients. An early diagnosis of a non-cardiac cause of pain should be made, ideally by the general practitioner, taking account of risk factors for cardiac as well as psychological disorder...

A 56 year old African American female who had a past medical history of transient ischemic attack in 2006 presented in our emergency department with first episode of sudden onset of severe central chest pain radiating to both arms , exaggerated by exertion, without any relieving factors, associated with nausea and sweating. She was taking baby aspirin, folic acid and multivitamin regularly. She...

Introduction The diagnosis of thoracic spondylodiscitis is challenging, given that it is a rare entity in itself and when unusual symptoms such as central chest pain predominate on presentation, it may pose a serious diagnostic challenge. Case Report A 54-year-old patient presented to accident and emergency with central chest pain and elevated inflammatory markers (C- reactive protein [CRP]: ...

Sir, We have read with interest the article on psychological factors in patients with normal and abnormal angiographic findings by Dave and Dhavale (1999) in Indian Journal of Psychiatry. The authors have brought out that patients with atypical chest pain had lower prevalence of type A behaviour and a unique 16-PF profile. However following points require reconsideration. Similar studies by Kat...

A 20-year-old man presented with a 6-month history of intermittent chest pain. Initial imaging demonstrated approximately 15 sewing needles lodged in his myocardium, predominantly in the left ventricle. The patient has been referred to cardiothoracic surgery for further management. His progress will be monitored closely.