Posts Tagged ‘chest pain’

A Man with Dyspnea and Chest Pain

Posted by • March 25th, 2016

In every patient with a large pulmonary embolus, one may consider the possibility that the embolus is caused by a benign cardiac tumor, primary cardiac cancer, or a metastasis to the heart. A 29-year-old man presented with severe dyspnea and chest pain on the right side. Computed tomographic angiography revealed a filling defect in the main and… Read More…

Dual Antiplatelet Therapy after Drug-eluting Stents

Posted by • November 16th, 2014

“Well, doc, it’s been a year!  Now what?” You first met your patient 12 months ago when he presented to the emergency department having a heart attack.  He was rushed to the cardiac catheterization lab, where a drug-eluting stent was placed to open the blocked coronary artery responsible for his crushing chest pain. He has done well… Read More…

Fevers, Chest Pain, and Substance-Use Disorder

Posted by • November 14th, 2014

In the latest Case Record of the Massachusetts General Hospital, a 31-year-old woman with substance-use disorder was admitted to this hospital because of fevers and chest pain. CT of the chest revealed multiple thick-walled nodular opacities throughout both lungs. Diagnostic tests were performed, and management decisions were made. Between 2007 and 2009 in the United States,… Read More…

Chest Pain and a Pleural Effusion

Posted by • May 30th, 2014

In the latest Case Record of the Massachusetts General Hospital, a 64-year-old man was admitted to the hospital with recurrent pleuritic chest pain. Imaging showed a loculated left pleural effusion and underlying consolidation in the left lower lobe. Treatment with antibiotics brought some improvement, but pain recurred and worsened. The differential diagnosis of a persistent pleuropulmonary… Read More…

A Curious Case of Chest Pain

Posted by • November 8th, 2013

In this new Clinical Problem-Solving article, a 67-year-old man presented to the emergency department with chest pain that had begun earlier that day and had progressed over a period of several hours. The pain was substernal and nonradiating, and it did not change with position or food intake. Although the detection of pulmonary edema on radiography… Read More…

Poorly Controlled Diabetes Mellitus and Fatigue

Posted by • May 31st, 2013

In the latest Case Record from the Massachusetts General Hospital, a 56-year-old woman with diabetes mellitus was admitted to the hospital because of hyperglycemia and chest pain. Approximately 4 years earlier, a chest radiograph showed a solitary pulmonary nodule in the right upper lobe.  The differential diagnosis for uncontrolled diabetes includes undertreatment or misdiagnosis of… Read More…

CT Angiography for Safe Discharge of Patients

Posted by • April 11th, 2012

Chest pain is the second most common reason for Emergency Room visits in this country, and although only 10-15% of patients admitted with chest pain are ultimately diagnosed with an acute coronary syndrome, the majority of patients get admitted. So common, in fact, is this admission diagnosis, that during cardiology rounds the other week, when… Read More…