A 50-year-old man with esophageal carcinoma developed severe, refractory, retrosternal chest pain. The diagnosis was made four days later when contrast studies showed an intramural dissecting hematoma of the esophagus. The patient responded to conservative management.

OBJECTIVE The pain following thoracic surgery and trauma is often refractory to conventional analgesic strategies. However, it shares key characteristics with neuropathic pain which gabapentin, an anticonvulsant, has been proven to effectively treat. To our knowledge, this is the first prospective study assessing the use of gabapentin in cardiothoracic surgery patients. METHODS Gabapentin was...

OBJECTIVE To determine the prevalence of anterior chest wall (ACW) pain in patients with recent inflammatory back pain (IBP) suggestive of spondyloarthritis (SpA), and to investigate the influence of ACW pain on the overall features of these patients. METHODS The DESIR cohort is a prospective, multicenter French cohort of patients with early IBP suggestive of SpA, including 708 patients (mean...

The case is a 52-year-old male admitted to cardiology department with chest tightness. Admission ECG showed nontypical T-wave changes in V2-V4 leads in pain peroids, and increasing severe narrowing of proximal LAD. Cardiac enzymes were abnormal. Emergency coronary angiography showed severe stenosis (99%) in proximal LAD.

one miscarriage. No definite history of syphilis, beyond falling of hair and occasional sore throat. Had typhoid fever ten years previously, and rheumatic fever fourteen years ago. No history of intemperance. Was first admitted to Bristol Royal Infirmary on November 4th, 1882, complaining of pain in right side of chest, dyspnoea, dysphagia, and other symptoms suggestive of aneurism. The patient...

BACKGROUND Obese people frequently suffer from shortness of breath and chest discomfort on exertion, and they often have a sedentary lifestyle. In the present study of patients with severe obesity, we investigated the effects of surgically induced weight loss on cardiorespiratory symptoms and leisure-time physical activity. METHODS The Swedish Obese Subjects study is an ongoing intervention t...

CASE REPORT A 47 year old lady had an acute severe episode of retrosternal chest pain, radiating to left arm and was diagnosed to have anteroseptal MI in a district hospital. The only cardiovascular risk factor was hypertension. Her vital signs were stable, Killips Class I. Thrombolysis with streptokinase and double antiplatelets acetylsalicylate 300mg and clopidogrel 300mg stat were administer...