Currently there is no definitive consensus regarding which is correct. The cardiac general visceral sensory pain fibers follow the sympathetics back to the spinal cord and have their cell bodies located in thoracic dorsal root ganglia 5.
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The week prior to presentation, she had been diagnosed with a Salmonella infection, which she acquired while on vacation. She had been treated with antibiotics, and the diarrhea she was experiencing had resolved.
One day later, she developed a pressure-like sensation in the center of her chest and she had difficulty catching her breath. When she called her primary care physician, she was instructed to go Chest pain case study the emergency department of the nearest hospital.
Her medical history was unremarkable and she had no risk factors for cardiovascular disease. Physical examination revealed her to be a thin female in no obvious distress.
Lungs were clear and cardiovascular examination revealed a friction rub heard best at the left lower sternal border. The patient complained that her pain became much worse when she was asked to lie flat on the examination table.
Electrocardiogram showed diffuse PR depression in the anterolateral leads, but no signs of acute ischemia.
The patient was admitted to the hospital for observation. Discussion Based upon the clinical presentation, this patient was diagnosed with acute pericarditis. She had a characteristic pericardial friction rub and her pain was exacerbated with lying down.
The presence of elevated inflammatory markers and the diffuse PR depression on the ECG were consistent with this diagnosis as well.
Pericarditis is an inflammation of the pericardium and may be caused by a number of entities. It is most commonly associated with neoplastic processes or viral infections, but can be associated with tuberculosis, bacterial infections, or unknown causes.
Additionally, it can be autoimmune in nature. Given this patient's recent history, her pericarditis was likely related to her Salmonella infection.
|Referred pain - Wikipedia||A clinical prediction rule for early discharge of patients with chest pain.|
The diagnosis of pericarditis is made using the tools noted above, including serum markers of inflammation and the ECG. Echocardiography can also be used to determine if a patient has a concomitant pericardial effusion. Presence of an effusion usually confirms the diagnosis of pericarditis, but its absence does not exclude it.
This patient had an echocardiogram that was negative for an effusion, but her clinical history was so suggestive of pericarditis that she was treated for it despite this negative finding. Patients with pericarditis do not usually need to be admitted to the hospital as this patient was.Hypertension, or abnormally high blood pressure, is often referred to as the “silent killer.” This is because it does not usually manifest any symptoms while causing damage to the heart, brain, kidneys, and eyes.
Case for Ischemia/infarct- The ST segements in the inferior leads show some minor elevation and straight ST segements with symmetrical T wave inversion. ** Tired Chest Pain Will Sleep Deprivation Kill You North Dakota ** Sleep Disorders Stories Texas Overlake Sleep Disorders Center Bellevue North Dakota Tired Chest Pain Will Sleep Deprivation Kill You North Dakota with Insomnia Natural Doctor Nyc Pennsylvania and Anxiety And Insomnia During Pregnancy New York Insomnia Exhaustion Mississippi.
Referred pain, also called reflective pain, is pain perceived at a location other than the site of the painful stimulus. An example is the case of angina pectoris brought on by a myocardial infarction (heart attack), where pain is often felt in the neck, shoulders, and back rather than in the thorax (chest), the site of the injury.
The International Association for the Study of Pain has not.
A year-old man presents to his local urgent care clinic for chest pain radiating up into his neck. He states that the pain started 5 hours ago and is gradually getting worse. A BNF case study in which a year-old man is admitted with a minute history of severe crushing chest pain.