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A 37-Year-Old Man With PleuriticChestPain. A 37-year-old man with poorly controlled type 2 diabetes presented with severe right-sided pleuriticchestpain, respiratory splinting, and cough. Two weeks earlier, he had been evaluated at an urgent care for cough and was prescribed a 5-day course of azithromycin for bronchitis. He then presented to our ED reporting mild, right-sided pleuriticchestpain. Vital signs were normal, and his chest radiograph showed a trace right pleural effusion (Fig (...) 1A). He was discharged with naproxen for pleurisy. Three days later, he returned, reporting a dramatic increase in the severity of his pleuriticchestpain and a cough that had become productive of yellow-brown sputum. He denied fever, but endorsed chills and night sweats. His medications included atorvastatin, lisinopril, metformin, and saxagliptin. His parents were from Guam, although he was born and raised in San Diego, CA. He was employed as a social worker and denied any history of cigarette
A 39-Year-Old Man With Diabetes, PleuriticChestPain, and Multiple Cavitary Lung Nodules. A 39-year-old male presented to the ED with a 2-day history of fever (Temperature-Maximum 39°C), nonbloody productive cough, and worsening right-sided pleuriticchestpain. The patient denied shortness of breath, nausea, vomiting, sinus symptoms, and abdominal pain. His medical history included type 2 diabetes mellitus (glycated hemoglobin, 11.1), hyperlipidemia, and depression. He smoked marijuana (...) but denied tobacco or illicit drug use. He reported no recent travels. He reported a 1-week history of left molar pain that began after he siphoned stagnant water with a straw from a refrigerator drip pan. He lived in Ohio all of his life. He denied any sick contacts. His medications include Lantus insulin at night, metformin, glimepiride, pravastatin, and Remeron.Published by Elsevier Inc.
Twenty-three year-old with pleuriticchestpain. A 23-year-old woman followed at another medical centre for congenital heart disease (CHD) presented to our emergency clinic with 3 weeks of bilateral pleuriticchestpain. She returned from holiday in Greece 6 weeks earlier where a tattoo and nasal piercing had been performed. There was no history of night sweats or fever.Her temperature was 37.5°C, heart rate 120 beats/min, oxygen saturations 94% on room air and blood pressure 110/74. Her chest (...) was clear and there was systolic murmur on auscultation. The chest radiograph showed peripheral bilateral lower zone atelectasis. The ECG demonstrated sinus tachycardia. The haemoglobin was 11.2 g/dL, white cell count 10.18×109/L, C-reactive protein 67 mg/L (normal <5 mg/L) and D dimer=430 ng/mL (normal <230 ng/mL).A pulmonary embolus was suspected and a CT pulmonary angiogram was performed (figure 1).Based on the CT findings, what is the most likely underlying congenital heart lesion in this patient
Epipericardial fat necrosis: Uncommon cause of acute pleuriticchestpain Epipericardial fat necrosis (EPFN) is a rare cause for acute chest. We describe the case of a previously healthy 25-year-old man who presented with sudden onset of left-sided chestpain. Laboratory values showed only mildly elevated d-dimer and electrocardiogram was normal. However, subsequent CT angiogram of the chest revealed fat necrosis in the epipericardial fat, characteristic for EPFN, for which the patient (...) was treated with nonsteroidal anti-inflammatory drug. This case highlights the importance of radiologists to consider the prospect of EPFN in the differential diagnosis of acute chestpain as correct diagnosis allows for conservative management and avoidance of more aggressive techniques in symptomatic patients.
An interesting case of recurrent shortness of breath and pleuriticchestpain Can you diagnose this case of a 58-year-old male with sudden-onset shortness of breath associated with sharp right-sided pleuriticchestpain? http://ow.ly/HLmk30j4DEH.
with vague nonspecific symptoms.A 43-year-old woman of Russian ethnicity with a history of nephrolithiasis presented to our emergency department with new left-sided pleuriticchestpain amid a 6-week history of constitutional symptoms including fevers, night sweats, and 7 kg of weight loss. Workup for acute coronary syndrome and pulmonary embolism in our emergency department was negative. Given that she was clinically unwell, she was admitted to internal medicine to expedite workup for the cause of her (...) Xanthogranulomatous pyelonephritis presenting as acute pleuriticchestpain: a case report Xanthogranulomatous pyelonephritis is a rare and serious manifestation of chronic kidney inflammation that can be life-threatening if not recognized and treated appropriately, often with antibiotics and surgery. Affected patients are most commonly females in their fifth or sixth decade of life with a background of obstructive uropathy, nephrolithiasis, or recurrent urinary tract infections who present
PleuriticChestPainPleuriticChestPain Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 PleuriticChestPainPleuriticChestPain (...) Aka: PleuriticChestPain , PleuriticPain , Pleurisy From Related Chapters II. Definition PleuriticChestPain (Symptom) exacerbated by forceful breathing Pleurisy Inflammation of parietal pleura One of many conditions resulting in PleuriticPain III. Pathophysiology Parietal pleura (not visceral) has s Irritated by inflammation or Nerve distribution Intercostal nerves referred to associated s Lateral hemidiaphragm Phrenic nerve referred to ipsilateral neck, Central hemidiaphragm IV. Causes
Does This Patient With ChestPain Have Acute Coronary Syndrome? Does This Patient With ChestPain Have Acute Coronary Syndrome? - Annals of Emergency Medicine Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 70, Issue 1, Pages 44–45 Does This Patient With ChestPain Have Acute Coronary Syndrome? x Sameer Sharif , MD (EBEM Commentator) , x Suneel Upadhye , MD, MSc (EBEM Commentator) Department of Medicine, McMaster University (...) /CSANZ rule Low to intermediate risk 0.24 (0.19–0.31) 10 Low CI , Confidence interval; HFA/CSANZ, Heart Foundation of Australia/Cardiac Society of Australia and New Zealand. Summary LR from studies that report original data at each threshold without combining across clinical decision rule thresholds. Table 2 Performance of select cardiac risk factors, chestpain characteristics, physical examination elements, and ECG findings in diagnosing acute coronary syndrome. Test No. of Studies No. of Patients
Pleuriticchestpain from portal hypertensive gastropathy in ESRD patient with autosomal dominant polycystic kidney disease misdiagnosed as pericarditis. Portal hypertensive gastropathy (PHG) is a gastric mucosal lesion complicating portal hypertension, with higher prevalence in decompensated cirrhosis. PHG can sometimes complicate autosomal dominant polycystic kidney disease (ADPKD) due to the presence of multiple liver cysts. Besides, PHG is known to present as chestpain, with or without (...) hematemesis. Other causes of chestpain in ADPKD include referred chestpain from progressively enlarging kidney cysts, and rare pericardial cysts. Chestpain, especially if pleuritic, in end-stage renal disease (ESRD) patients, is often ascribed to uremic pericarditis. We present recurrent pleuriticchestpain in a 24-year old ESRD patient with ADPKD that was initially misdiagnosed as uremic pericarditis. It was ultimately shown to represent symptomatic PHG with excellent therapeutic response to proton
Unusual cause of pleuriticchestpain in a child We present the case of a 5-year-old boy with hereditary multiple exostoses who presented with left-sided pleuriticchestpain. A CT scan of the chest revealed an intrathoracic exostosis in close association with the heart.2016 BMJ Publishing Group Ltd.
A 19-year-old woman with pleuriticchestpain 26015794 2015 05 27 2018 11 13 1712-9532 26 2 2015 Mar-Apr The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale Can J Infect Dis Med Microbiol A 19-year-old woman with pleuriticchestpain. 100-2 Khasawneh Faisal A FA Section of Infectious Diseases, Department of Internal Medicine, Texas Tech University Health Science Center; Mehmood Mansoor M Section (...) of Infectious Diseases, Department of Internal Medicine, Texas Tech University Health Science Center; Halloush Ruba A RA Amarillo Pathology Group, Amarillo, Texas, USA. eng Journal Article Egypt Can J Infect Dis Med Microbiol 101226876 1712-9532 2015 5 28 6 0 2015 5 28 6 0 2015 5 28 6 1 ppublish 26015794 PMC4419811 Antimicrob Agents Chemother. 2011 May;55(5):2478-80 21402857 Chest. 2000 Jun;117(6):1672-8 10858401 Intern Med. 2010;49(12):1163-9 20558936 Antimicrob Agents Chemother. 2007 Nov;51(11):4211-3
Pleuriticchestpain and globus pharyngeus. 26009748 2015 08 04 2015 05 26 1533-7294 64 5 2015 May The Journal of family practice J Fam Pract Pleuriticchestpain and globus pharyngeus. 305-7 Gawrys Breanna B Fort Belvoir Community Hospital, Family Medicine Residency, VA, USA. Email: email@example.com. Shaha David D Fort Belvoir Community Hospital, Family Medicine Residency, VA, USA. eng Case Reports Journal Article United States J Fam Pract 7502590 0094-3509 0 Anti-Inflammatory (...) Agents, Non-Steroidal AIM IM Acute Coronary Syndrome diagnosis Adult Anti-Inflammatory Agents, Non-Steroidal therapeutic use ChestPain diagnosis etiology Deglutition Disorders diagnosis etiology Female Humans Mediastinal Emphysema complications diagnosis Mediastinitis diagnosis Pericarditis diagnosis Radiography, Thoracic methods Treatment Outcome 2015 5 27 6 0 2015 5 27 6 0 2015 8 5 6 0 ppublish 26009748 jfp_6405m
Does This Patient With ChestPain Have Acute Coronary Syndrome? TAKE-HOME MESSAGE Theaccuracyofindividualriskfactors,symptoms,andsignsinisolationtodiagnoseacute coronary syndrome is poor.Thehistory, ECG, age, risk factors,and troponin score (HEART) and the Thrombolysisin MyocardialInfarction (TIMI) score have strong diagnosticvalueandshouldbeusedaspartoftheclinicalassessmentofthesepatients. Does This Patient With ChestPain Have Acute Coronary Syndrome? EBEM Commentators Sameer Sharif, MD (...) to intermediate risk 0.24 (0.19–0.31) 10 Low CI, Con?dence interval; HFA/CSANZ, Heart Foundation of Australia/Cardiac Society of Australia and New Zealand. *SummaryLRfromstudiesthatreportoriginaldata ateachthresholdwithoutcombiningacrossclinicaldecision rule thresholds. Table 2. Performance of select cardiac risk factors, chestpain characteristics, physical examination elements, and ECG ?ndings in diagnosing acute coronary syndrome.* Test No. of Studies No. of Patients Risk of Bias LRD (95% CI) LR– (95% CI
A 29 year old male with pleuriticchestpain for 6 hours Dr. Smith's ECG Blog: A 29 year old male with pleuriticchestpain for 6 hours Thursday, June 26, 2014 This case was sent to me by Taylor Sanders of the LSU- Baton Rouge Emergency Medicine residency. A 29 year old complained of 6 hours of pleuriticchestpain: QRS: There is rSR' in V1, consistent with RV conduction delay, but the QRS does not appear prolonged and there are no S-waves in lateral leads. However, this absence of lateral S (...) unplublished study of inferior STEMI, only 7% had a QTc less than or equal to 380ms. I was shown this ECG with just the clinical information above. I responded that this is probably myo- or peri-carditis but that I was worried about the size of the T-waves. And I often say the "you diagnose pericarditis at your peril." The fact that the pain was pleuritic and the patient was 29 years old is supportive of pericarditis, but The first troponin I returned at 6 ng/mL (significantly elevated). Another ECG
patient with pleuriticchestpain at inclusion Procedure: Lung ultrasound Lung ultrasonography performed and interpreted by a physician (Pulmonologist or Emergency Physician) possessing specific knowledge in the procedure and a training of at least 100 thoracic ultrasonographies in accordance to a prespecified protocol. Other Name: Lung sonography Outcome Measures Go to Primary Outcome Measures : Sensitivity and specificity of lung ultrasound in pneumonia, chest wall pain, lung cancer, pulmonary (...) embolism or other causes in patients presenting with pleuriticchestpain. [ Time Frame: 30 days ] Sensitivity and specificity, positive and negative predictive values of lung ultrasound in pneumonia, chest wall pain, lung cancer, pulmonary embolism or other causes in patients presenting with pleuriticchestpain. Secondary Outcome Measures : Accuracy of ultrasound in distinguishing lung consolidation in pneumonia, atelectasis, pulmonary infarction or tumors [ Time Frame: 30 days ] Accuracy
Pleuriticchestpain in a 58-year-old man. 24647053 2014 09 12 2016 11 25 1468-201X 100 16 2014 Aug Heart (British Cardiac Society) Heart Pleuriticchestpain in a 58-year-old man: gastro-pericardial fistula. 1271, 1300 10.1136/heartjnl-2014-305663 Cudmore Jessica A JA Department of Internal Medicine, University of Manitoba, Winnipeg, Canada. Lam Wilson W Department of Diagnostic Radiology, University of Manitoba, Winnipeg, Canada. Kirkpatrick Iain D C ID Department of Diagnostic Radiology (...) , University of Manitoba, Winnipeg, Canada. Seifer Colette M CM Department of Internal Medicine, University of Manitoba, Winnipeg, Canada. eng Case Reports Journal Article 2014 03 19 England Heart 9602087 1355-6037 AIM IM Heart. 2014 Aug;100(16):1301 24829368 ChestPain diagnosis etiology physiopathology Decompression, Surgical methods Diagnosis, Differential Drainage methods Electrocardiography methods Gastrectomy adverse effects Humans Intestinal Fistula complications diagnosis physiopathology surgery
PleuriticChestPain in a Young Female: A Reminder for Acute Health Care Providers Chestpain is one of the most common reasons for emergency department visits. Emergency medicine doctors should focus their initial assessment on patients' stability. History, physical examination, and ancillary testing should exclude serious causes such as acute coronary syndrome, acute aortic syndromes, pulmonary embolism, pneumothorax, esophageal perforation, and rupture as well as pericardial tamponade. Young