1/11. Differential diagnosis of chest pain: a case report.chest pain in a common presenting complaint in many healthcare settings, including Gl settings. It may be caused by a variety of cardiac and noncardiac abnormalities. nurses can play a critical role in the differential diagnosis of chest pain by obtaining a thorough history and conducting a directed physical examination. This article describes the differential diagnosis of chest pain through a case presentation.- - - - - - - - - - ranking = 1keywords = chest pain (Clic here for more details about this article) |
2/11. diabetes insipidus in a patient with a highly malignant B-cell lymphoma and stomatitis.A 37-year-old male patient with a diffuse pleomorphic B-cell-lymphoma, which has been diagnosed two month earlier with the primary site at the pterygopalatine fossa on both sides with infiltration of the clivus and cavernous sinus was referred to our hospital for continuation of the third course of CHOP chemotherapy. At admission he reported about a recent history of painful swallowing and intermittent substernal chest pain. Alleviation of the pain on swallowing and the chest pain was apparently only possible by drinking 10 to 15 l of cold coca cola throughout the day and night, a regimen that resulted in polyuria. physical examination revealed extensive thrush stomatitis and soor esophagitis. Despite successful treatment with fluconazole, polydipsia continued unabated. The classic osmotic test of dehydration and exogenous vasopressin revealed hypothalamic diabetes insipidus (DI). Basal hormones and stimulated endocrine function tests of the adenohypophysis were found to be normal. MRI-scan revealed lymphoma infiltration of the neurohypophysis. After the third course of CHOP chemotherapy the patient surprisingly recovered completely from his excessive thirst. The present report shows that clinical disorders such as thrush stomatitis can mask diabetes insipidus caused by an early relapsing lymphoma.- - - - - - - - - - ranking = 0.33333333333333keywords = chest pain (Clic here for more details about this article) |
3/11. Tuberculous involvement of the oesophagus with oesophagobroncheal fistula.Tuberculous involvement of the oesophagus is a rare disease. Even if it is suspected, diagnosis is often difficult though dysphagia and chest pain are the most common symptoms without any other specific signs of tuberculosis. The diagnosis is based on oesophagography, oesophagoscopy, bronchoscopy, and computed tomographic scan. Suspected tuberculosis can be confirmed with histology, smear, and culture. The two most common differential diagnoses are Crohn's disease and carcinoma. The case is reported of a female patient with tuberculous involvement of the oesophagus, who developed an oesophagobroncheal fistula during steroid treatment started for suspicion of Crohn's disease. The patient was immunocompromised due to treatment with azathioprine that she was receiving for multiple sclerosis. The fistula was successfully treated by antituberculous chemotherapy alone.- - - - - - - - - - ranking = 0.16666666666667keywords = chest pain (Clic here for more details about this article) |
4/11. doxycycline-induced pill esophagitis.Pill-induced esophagitis is a complication seen in patients who use certain medications such as tetracycline and non-steroidal anti-inflammatory drugs. In this short report, we described five cases of doxycycline-induced esophagitis with endoscopic images. All of the patients were young or middle-aged women. Dysphagia or odynophagia with retrosternal pain were the main presenting symptoms in all cases. The observed injuries were at the middle third of esophagus with a normal surrounding mucosa. All patients had a history of swallowing the capsule with a small amount of water or in a recumbent position. Two patients with dysphagia were managed by intravenous fluid support and parenteral acid suppression. The symptoms were improved in 2-7 days after the ceasing of the drug and control endoscopies were completely normal in all cases after 3-4 weeks of admission. The drug-induced esophagitis is not rare with certain drugs and should be suspected in all patients presenting with chest pain and dysphagia. physicians must warn the patients to take the pills and capsules with enough liquid and in the upright position.- - - - - - - - - - ranking = 0.16666666666667keywords = chest pain (Clic here for more details about this article) |
5/11. herpes simplex esophagitis in the immunocompetent patient: report of four cases and review.Esophagitis due to herpes simplex virus is a well-recognized entity in immunocompromised patients but has only rarely been described in apparently immunocompetent hosts. We report four cases and review 27 additional cases identified in the English-language literature. Odynophagia, retrosternal chest pain, and fever are the most common symptoms. Single-contrast esophagography is insensitive and nonspecific, but double-contrast esophagography may be of more diagnostic value. esophagoscopy with biopsy or collection of aspirate for cytologic examination and culture are required to make a definitive diagnosis. patients are predominantly male, and most cases are associated with primary infection. Viral isolates were typed in 13 cases and were always type 1. herpes simplex esophagitis in the immunocompetent patient is a self-limited infection; however, therapy with acyclovir may attenuate infection and hasten resolution of symptoms.- - - - - - - - - - ranking = 0.16666666666667keywords = chest pain (Clic here for more details about this article) |
6/11. Acquired QT prolongation associated with esophagitis and acute weight loss: how to evaluate a prolonged QT interval.When the physician is confronted with a patient having significant QT prolongation, it is critical to determine whether the patient harbors a genetic defect and a transmissible form of long qt syndrome (LQTS) or whether the QT prolongation has an acquired cause. The distinction has profound ramifications for the type of care provided to the patient and family. We report the case of a previously healthy 14-year-old boy who presented with a 10-day history of painful swallowing, a 10-lb weight loss, and chest pain. A 12-lead electrocardiogram (ECG) showed marked QT prolongation. endoscopy and culture identified a herpes simplex esophageal ulcer. After treatment with acyclovir, the patient recovered completely. Three weeks after the resolution of his symptoms and recovery from his acute weight loss, a follow-up ECG showed complete normalization of the QT interval. This case illustrates yet another potential mechanism for acquired QT prolongation. We also provide a diagnostic algorithm for the careful evaluation of a prolonged QT interval.- - - - - - - - - - ranking = 0.16666666666667keywords = chest pain (Clic here for more details about this article) |
7/11. Spontaneous esophageal perforation in herpes simplex esophagitis.A 32-yr-old, previously healthy man with severe chest pain of sudden onset was found to have purulent pericarditis and pleural effusions. Several days later, an esophagogram revealed a perforation of the thoracic esophagus. endoscopy showed a picture highly suggestive of a late stage of an extensive herpes simplex virus (HSV) esophagitis. Biopsies revealed evidence of massive HSV infection, confirmed by immune microscopy and virus culture. At surgery, a mediastinal abscess was found, and an esophageal perforation was identified. These findings suggest that the etiology of the perforation was an unusually severe herpetic infection. To our knowledge, HSV esophagitis has not previously been implicated as the cause of spontaneous esophageal perforation.- - - - - - - - - - ranking = 0.16666666666667keywords = chest pain (Clic here for more details about this article) |
8/11. Medication-induced esophagitis in children.Clinical and endoscopic features of two pediatric cases of esophageal ulcers caused by capsules of oxytetracycline and doxycycline are described. Several cases of medication-induced esophageal injury in children have been reported until now, all of which were in association with tablets or capsules. Antibiotics are known to be responsible for medication-induced esophagitis in adults. In this study, 4 cases were caused by emepronium bromide and 3 cases, including the present patients, by antibiotics. All cases but one complained of chest pain and/or dysphagia. Although the interval between the onset of the symptoms and the diagnosis varied among cases, the clinical courses were relatively uneventful, without any long-term sequelae. This clinical entity seems to be unfamiliar to pediatricians and is omitted from the differential diagnosis.- - - - - - - - - - ranking = 0.16666666666667keywords = chest pain (Clic here for more details about this article) |
9/11. Slipping rib syndrome as a cause of chest pain in children.Four patients with the slipping rib syndrome presenting as chest pain are described, and the appropriate literature is reviewed. In two of the patients the physicians caring for the children were initially concerned that a cardiac condition was the cause of the chest pain, and a cardiac evaluation was done. In one patient an emotional cause for the pain was first considered and then a cardiac cause was pursued. In the last patient esophagitis was thought to be the cause and the child was referred to a gastroenterologist. It is suggested that slipping rib syndrome should be considered by physicians when evaluating children with a complaint of chest pain. The condition can be easily diagnosed on physical examination and therefore may save some patients from an unnecessary cardiac or gastroentestinal evaluation.- - - - - - - - - - ranking = 1.1666666666667keywords = chest pain (Clic here for more details about this article) |
10/11. chest pain in an aspirin-sensitive asthmatic patient. eosinophilic esophagitis causing esophageal dysmotility.We describe a case of eosinophilic esophagitis in a 38-year-old man with aspirin-sensitivity asthma which presented as noncardiac chest pain. Manometric measurements demonstrated tertiary contractions. Biopsies showed a dense eosinophilic infiltrate in the mucosa. There was no response to therapy for reflux. Symptoms quickly resolved with corticosteroid therapy. Subsequent manometric values recorded after corticosteroid therapy showed resolution of the dysmotility. Biopsies showed normal mucosa. adult asthmatic subjects with noncardiac chest pain should receive further investigation if reflux therapy fails to resolve the symptoms.- - - - - - - - - - ranking = 0.33333333333333keywords = chest pain (Clic here for more details about this article) |
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