Rare Presentation of Pleuritic Chest Pain

Kulothungan Gunasekaran; Swetha Murthi; Narmadha Panneerselvam; Nazir Lone; Karen McGinnis

doi:10.1378/chest.2270703

A Rare Case of Cyclical Hemothorax: Thoracic Endometriosis Syndrome

Case Reports in Pulmonology ◽

10.1155/2018/9830797 ◽

2018 ◽

Vol 2018 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Muhammad Shabbir Rawala ◽

Muhammad Farhan Khaliq ◽

Muhammad Asif Iqbal ◽

S. Tahira Shah Naqvi ◽

Kinaan Farhan ◽

...

Keyword(s):

Chest Pain ◽

Pleural Effusion ◽

Reproductive Age ◽

Common Disease ◽

Pleuritic Chest Pain ◽

Rare Presentation ◽

Ct Guided ◽

Endometrial Cells ◽

Wide Range ◽

Thoracic Endometriosis

Endometriosis is a common condition in which endometrial cells and stroma are deposited in extrauterine sites. Its prevalence has been estimated to be 10% of reproductive age females. It is commonly found in the pelvis; however, it may be found in the abdomen, thorax, brain, or skin. Thoracic involvement is a relatively rare presentation of this common disease. Thoracic endometriosis commonly presents as pneumothorax in 73% of patients. A rarer presentation of thoracic endometriosis is hemothorax (<14%) or hemoptysis (7%). Thoracic endometriosis is an uncommon cause of a pleural effusion. We present a case of 28-year-old African American female with no other medical conditions. She presented to the hospital with worsening right-sided pleuritic chest pain, dyspnea, and menorrhagia. She had been complaining of pleuritic chest pain for 5 years, the onset of which corresponds to the start of her menstrual cycle and is relieved with cessation of menses. Initial laboratory studies revealed a severe microcytic anemia with normal coagulation profile. Chest X-ray showed small right pleural effusion and suspicious for airspace disease. A computed tomography (CT) of chest was ordered for further clarification and identified large right pleural effusion. CT-guided thoracentesis removed 500 ml of serosanguinous fluid consisting of blood elements. There can be multiple sites involved with endometriosis and can present with wide range of symptoms that occur periodically with menses in young woman. The history and pleural fluid findings of this case are suggestive of Thoracic Endometriosis Syndrome. The diagnosis of this is often missed or delayed by clinicians, which can result in recurrent hospitalization and other complications. As internists we should be suspicious of atypical presentations of endometriosis and treat them early before complications develop. This case also highlights the importance of suspecting atypical etiologies for pleural effusion.

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Twenty-three year-old with pleuritic chest pain

Heart ◽

10.1136/heartjnl-2017-312718 ◽

2018 ◽

Vol 105 (6) ◽

pp. 464-469

Author(s):

Karina P Gopaul ◽

Helen M Parry ◽

Damien Cullington

Keyword(s):

Chest Pain ◽

Congenital Heart ◽

White Cell Count ◽

Coarctation Of The Aorta ◽

List Type ◽

Pleuritic Chest Pain ◽

Reactive Protein ◽

Pulmonary Angiogram ◽

Night Sweats ◽

Ct Pulmonary Angiogram

Clinical introductionA 23-year-old woman followed at another medical centre for congenital heart disease (CHD) presented to our emergency clinic with 3 weeks of bilateral pleuritic chest pain. 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).QuestionBased on the CT findings, what is the most likely underlying congenital heart lesion in this patient?Bicuspid aortic valveCoarctation of the aortaFontan circulationParachute mitral valveVentricular septal defectFigure 1CT pulmonary angiogram (coronal views).

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P3.CR-33 Trichoptysis, Hemoptysis and Chest Pain: A Very Rare Presentation of Anterior Mediastinal Teratoma in a Young Patient

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2018.08.2012 ◽

2018 ◽

Vol 13 (10) ◽

pp. S1040-S1041

Author(s):

A. Saidane ◽

B. Dhahri ◽

H. Cherif ◽

H. Aouina

Keyword(s):

Chest Pain ◽

Young Patient ◽

Rare Presentation ◽

Mediastinal Teratoma

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Acute Pleuritic Chest Pain and Lung Mass in an Elderly Woman

CHEST Journal ◽

10.1378/chest.97.6.1473 ◽

1990 ◽

Vol 97 (6) ◽

pp. 1473-1474 ◽

Cited By ~ 9

Author(s):

Denis D. Bensard ◽

John A. St. Cyr ◽

Michael R. Johnston

Keyword(s):

Chest Pain ◽

Elderly Woman ◽

Lung Mass ◽

Pleuritic Chest Pain

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Pleural Effusions: Diagnostic Considerations

Pediatrics in Review ◽

10.1542/pir.16.2.79 ◽

1995 ◽

Vol 16 (2) ◽

pp. 79-79

Author(s):

Jeffrey M. Ewig

Keyword(s):

Chest Pain ◽

Pleural Space ◽

Pleural Effusions ◽

Pleuritic Chest Pain ◽

Radiographic Appearance ◽

Air Bubble ◽

Presenting Symptoms ◽

Breath Sounds ◽

Costophrenic Angle ◽

Pleural Involvement

The presence of fluid in the pleural space can be seen in a variety of disorders. Presenting symptoms include dyspnea, pleuritic chest pain, and ipsilateral shoulder pain if pleural involvement occurs at the central portion of the diaphragm. Physical examination findings include chest asymmetry, diminished breath sounds, dullness to percussion, and decreased tactile fremitus. In an upright patient, the radiographic appearance of pleural fluid includes blunting of the costophrenic angle, straightening or a more lateral peak of the hemidiaphragm contour, simulation of an elevated hemidiaphragm, or a distance of greater than 2 cm between the gastric air bubble and the lung.

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A rare case of spontaneous haemothorax in patient with haemophilia A

BMJ Case Reports ◽

10.1136/bcr-2021-242412 ◽

2021 ◽

Vol 14 (4) ◽

pp. e242412

Author(s):

Suthaphong Tripoppoom ◽

Nophol Leelayuwatanakul

Keyword(s):

Chest Pain ◽

Rare Case ◽

Rare Event ◽

Haemophilia A ◽

Minor Trauma ◽

Conservative Approach ◽

Pleuritic Chest Pain ◽

Good Clinical Outcome ◽

History Of

Haemorrhage in patients with haemophilia is common after minor trauma but may occur spontaneously. Despite the diversity of bleeding sites, spontaneous haemothorax, on a non-traumatic basis, is an exceedingly rare event and only a few cases had been reported. We present a case of a 43-year-old man with a history of haemophilia A who had pleuritic chest pain for 1 day without significant history of trauma. Diagnostic thoracentesis showed bloody pleural fluid in which neither abnormal cell nor organism was found. He was treated by cryoprecipitate replacement and therapeutic thoracentesis for releasing haemothorax. After discharge, the patient returned for follow-up with complete radiological resolution. Regarding the consequences of retained haemothorax from conservative approach and the procedure-related bleeding of given therapeutic intervention in haemothorax making its management in patients with haemophilia to be more challenging. Our case illustrates a conservative treatment of spontaneous haemothorax in patient with haemophilia resulting in a good clinical outcome.

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