scholarly journals Left Ventricular Pseudoaneurysm Dissecting into Anterior Chest Wall – A Rare Cause of Sudden Onset Excruciating Chest Pain

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Rakshita Chandrashekar ◽  
Monoj Konda ◽  
Vishal Gupta ◽  
Jagadeesh Kalavakunta
Keyword(s):  
Chest Pain ◽  
Chest Wall ◽  
Anterior Chest Wall ◽  
Sudden Onset ◽  
Left Ventricular ◽  
Left Ventricular Pseudoaneurysm

Picture Quiz: A Case of Sudden Severe Chest Pain

2007 ◽  
Vol 6 (1) ◽  
pp. 27-27
Author(s):  
Mustafa Abu Rabia ◽  
◽  
P Sullivan ◽  
Stavros M Stivaros. ◽  
◽  
...  
Keyword(s):  
Chest Pain ◽  
Medical History ◽  
Chest Wall ◽  
Epigastric Pain ◽  
Anterior Chest Wall ◽  
Sudden Onset ◽  
Severe Chest Pain ◽  
History Of ◽  
Previous Medical History

An 18-year-old male with no previous medical history presented to hospital with sudden onset of acute epigastric pain radiating to the anterior chest wall and both shoulders. There was no history of recent trauma and he had not been vomiting.

scholarly journals Noncompaction and Takotsubo Syndrome in a Neuromuscular Disorder

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Josef Finsterer ◽  
Claudia Stöllberger ◽  
Walter Benedikt Winkler
Keyword(s):  
Chest Pain ◽  
Beta Blockers ◽  
Liver Cyst ◽  
Neuromuscular Disorder ◽  
Sudden Onset ◽  
Left Ventricular ◽  
Takotsubo Syndrome ◽  
Troponin Elevation ◽  
History Of ◽  
St Elevation

Background. Takotsubo syndrome (TTS) in patients with left ventricular hypertrabeculation/noncompaction (LVHT) has been reported in four patients, and a TTS plus LVHT plus a neuromuscular disorder (NMD) was only reported once so far. Here, we present the fifth patient with LVHT and TTS and the second patient with LVHT, TTS, and a NMD. Methods and Results. The patient is a 68 yo female hobby choir singer with a history of skin dermatofibroma, skin fibrokeratoma, arterial hypertension, hyperlipidemia, hypothyroidism, anemia, hyponatremia, diverticulosis, LVHT detected at age 60 y, five syncopes, a liver cyst, and carotid endarterectomy 2 months prior to admission because of sudden-onset chest pain. Workup revealed ST elevation, troponin elevation, and mild coronary artery sclerosis. Ventriculography and transthoracic echocardiography (TTE) showed the apical type of a TTS. ECG normalised within 10 w and TTE within 6 w under beta-blockers and ATII-blockers. The TTS was triggered by being offended of being unable to sing anymore after endarterectomy. Neurological workup suggested the presence of a NMD. Conclusions. This case shows that LVHT occurs in NMD patients and that patients with LVHT and a NMD may develop a TTS. Whether patients with LVHT and a NMD are particularly prone to develop a TTS requires further confirmation. NMD patients with LVHT should avoid stress not to trigger a TTS.

Surgical treatment of a chest-wall penetrating left ventricular pseudoaneurysm

2000 ◽  
Vol 70 (1) ◽  
pp. 275-276 ◽  
Author(s):  
Matthias Bauer ◽  
Michele Musci ◽  
Miralem Pasic ◽  
Friedrich Knollmann ◽  
Roland Hetzer
Keyword(s):  
Surgical Treatment ◽  
Chest Wall ◽  
Left Ventricular ◽  
Left Ventricular Pseudoaneurysm

scholarly journals Integrating Osteopathic Evaluation and Treatment in a Case Report of Acute Chest Pain

2019 ◽  
Vol 29 (2) ◽  
pp. 27-30
Author(s):  
Sheldon. C. Yao
Keyword(s):  
Health Care ◽  
Differential Diagnosis ◽  
Chest Pain ◽  
Chest Wall ◽  
Financial Burden ◽  
Acute Chest Pain ◽  
Anterior Chest Wall ◽  
Patient Response ◽  
Pain Syndromes ◽  
Musculoskeletal Education

Abstract Chest pain is an emergent presentation associated with a wide differential diagnosis including cardiac, pulmonary, gastrointestinal, and musculoskeletal origins. The evaluation of acute chest pain can be costly and can be a financial burden on the health care system. Integrating osteopathic diagnosis and treatment can assist with identifying and alleviating potential musculoskeletal sources of pain. This case illustrates how applying osteopathic manipulative medicine (OMM) benefited a 61-year-old woman presenting with anterior chest wall pain. Patient response to OMM can assist physicians with better managing acute chest wall pain syndromes. Improved musculoskeletal education can potentially improve medical management of chest pain of musculoskeletal origin.

scholarly journals Previously undiagnosed scoliosis presenting as pleuritic chest pain in the emergency department – a case series and a validating retrospective audit

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gabor Xantus ◽  
Derek Burke ◽  
Peter Kanizsai
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Chest Wall ◽  
Adult Population ◽  
Case Series ◽  
Sudden Onset ◽  
Pleuritic Chest Pain ◽  
Record System ◽  
Diverse Range ◽  
Retrospective Audit

Abstract Background Chest pain is one of the commonest presenting complaints in urgent/emergency care, with a lifelong prevalence of up to 25% in the adult population. Pleuritic chest pain is a subset of high investigation burden because of a diverse range of possible causes varying from simple musculoskeletal conditions to pulmonary embolism. Case series Among otherwise fit and healthy adult patients presenting in our emergency department with sudden onset of unilateral pleuritic chest pain, within 1 month we identified a cohort of five patients with pin-point tenderness in one specific costo-sternal joint often with referred pain to the back. All cases had apparent and, previously undiagnosed mild/moderate scoliosis. Methods To confirm and validate the observed association between scoliosis and pleuritic chest pain, a retrospective audit was designed and performed using the hospital’s electronic medical record system to reassess all consecutive adult chest pain patients. Results The Odds Ratio for having chest pain with scoliosis was 30.8 [95%CI 1.71–553.37], twenty times higher than suggested by prevalence data. Discussion In scoliosis the pathologic lateral curvature of the spine adversely affects the functional anatomy of both the spine and ribcage. In our hypothesis the chest wall asymmetry enables minor slip/subluxation of a rib either in the costo-sternal and/or costovertebral junction exerting direct pressure on the intercostal nerve causing pleuritic pain. Conclusion Thorough physical examination of the anterior and posterior chest wall is key to identify underlying scoliosis in otherwise fit patients presenting with sudden onset of pleuritic pain. Incorporating assessment for scoliosis in the low-risk chest pain protocols/tools may help reducing the length of stay in the emergency department and, facilitate speedy but safe discharge with increased patient satisfaction.

scholarly journals Myocardial rupture and left ventricular pseudoaneurysm due to late STEMI presentation during the COVID-19 pandemic lockdown: a classical case report

2021 ◽  
Vol 5 (7) ◽  
Author(s):  
Audra Banisauskaite ◽  
Periaswamy Velavan ◽  
Jonathan Hasleton ◽  
Neeraj Mediratta ◽  
Monika Arzanauskaite ◽  
...  
Keyword(s):  
Chest Pain ◽  
Systolic Function ◽  
Multimodality Imaging ◽  
Cardiac Computed Tomography ◽  
Rare Complication ◽  
Left Ventricular ◽  
True Aneurysm ◽  
Circumflex Artery ◽  
Left Ventricular Pseudoaneurysm ◽  
Lv Systolic Function

Abstract Background Left ventricular (LV) pseudoaneurysm is a serious and rare complication of myocardial infarction (MI). It occurs when an injured myocardial wall ruptures and is contained by overlying adherent pericardium or scar tissue, most commonly it develops in patients with late presentation of MI and delayed revascularization. Case summary A 64-year-old man presented to the emergency department with intermittent central chest pain radiating to back and neck and increasing on deep inspiration, which was considered to be of musculoskeletal origin for a week, but worsened despite medications. Electrocardiography showed features of ST-elevation MI; a circumflex artery occlusion was found on coronary angiogram and angioplasty was performed. Cardiovascular magnetic resonance (CMR) revealed features of healed lateral wall rupture with adherent parietal pericardium and the patient was managed conservatively. Two months later the patient returned with severe chest pain; echocardiogram and cardiac computed tomography showed significant interval progression of the pseudoaneurysm. Aneurysmectomy was performed, after which the patient recovered and had none of the previous symptoms since. Follow-up CMR study revealed improvement of LV systolic function. Discussion A rare case of post-infarction LV pseudoaneurysm was reported. Multimodality imaging helped to detect and to differentiate this complication from the true aneurysm and to follow it up and plan the treatment. Conservative treatment was not effective in this case as the pseudoaneurysm progressed; aneurysmectomy helped to improve LV systolic function.

Left ventricular pseudoaneurysm protruding outside the chest wall

2006 ◽  
Vol 7 (10) ◽  
pp. 779
Author(s):  
Mauro Colletta ◽  
Andrea Rubboli ◽  
Giuseppe Di Pasquale
Keyword(s):  
Chest Wall ◽  
Left Ventricular ◽  
Left Ventricular Pseudoaneurysm

scholarly journals Getting to a Man's Heart through His Colon

2016 ◽  
Vol 43 (2) ◽  
pp. 168-170
Author(s):  
Marc D. Samsky ◽  
Adam D. DeVore ◽  
Michael Durkin ◽  
Jason E. Stout ◽  
Eric J. Velazquez ◽  
...  
Keyword(s):  
Artery Bypass ◽  
Anterior Chest Wall ◽  
Left Ventricular ◽  
Left Ventricular Cavity ◽  
Delayed Presentation ◽  
Left Ventricular Pseudoaneurysm ◽  
Pulsatile Mass ◽  
Dor Procedure ◽  
Dacron Patch ◽  
Stich Trial

A 69-year-old man presented with a progressively enlarging pulsatile mass in the left side of his chest. Because of a history of an ischemic cardiomyopathy, he had been randomized in 2003 to undergo coronary artery bypass grafting with a Dor procedure, as part of the Surgical Treatment for Ischemic Heart Failure (STICH) trial. Our patient's imaging studies, including a thoracic computed tomogram and transthoracic echocardiogram, were now of concern for left ventricular pseudoaneurysm. He was taken immediately for surgical exploration. Purulent material, with empyema, extended from the anterior chest wall through the chest cavity into the mediastinum, with communication into the pericardial space. Notably, there was no compromise of the left ventricular cavity, and there was no pseudoaneurysm. The chest was copiously irrigated before closure. The epicardial patch placed 10 years earlier in the STICH trial was not thought to be the nidus of the abscess and was therefore not removed. Three months later, the patient presented again, this time with hemorrhagic shock and bleeding from his left anterior thoracotomy site, which we then re-entered. He was found to have a left ventricular pseudoaneurysm with disruption of the ventricular apex. The epicardial felt-and-Dacron patch, placed 10 years previously during his Dor procedure, was found to be infected with Clostridium difficile and was removed. The left ventricular apex was repaired. Whereas C. difficile bacteremia is rare, the seeding of prosthetic cardiac material with delayed presentation, as in this case, is extraordinarily uncommon.

scholarly journals Mesalamine-Induced Myocarditis and Coronary Vasculitis in a Pediatric Ulcerative Colitis Patient: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Elimarys Perez-Colon ◽  
Gul H. Dadlani ◽  
Ivan Wilmot ◽  
Michelle Miller
Keyword(s):  
Ulcerative Colitis ◽  
Chest Pain ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Sudden Onset ◽  
Left Ventricular ◽  
Cardiovascular Toxicity ◽  
Ventricular Systolic Function ◽  
Drug Induced ◽  
Coronary Ectasia

Mesalamine-containing products are often a first-line treatment for ulcerative colitis. Severe adverse reactions to these products, including cardiovascular toxicity, are rarely seen in pediatric patients. We present a case of a 16-year-old boy with ulcerative colitis treated with Asacol, a mesalamine-containing product, who developed sudden onset chest pain after four weeks on therapy. Serial electrocardiograms showed nonspecific ST segment changes, an echocardiogram showed mildly decreased left ventricular systolic function with mild to moderate left ventricular dilation and coronary ectasia, and his troponins were elevated. Following Asacol discontinuation, his chest pain resolved, troponins were trending towards normal, left ventricular systolic function normalized, and coronary ectasia improved within 24 hours suggesting an Asacol-associated severe drug reaction. Mesalamine-induced cardiovascular toxicity, although rare, may represent a life-threatening disorder. Therefore, every patient presenting with acute chest pain should receive a workup to rule out this rare drug-induced disorder.

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