Case Study: Emergency Medicine Chest Pain In a Previously Healthy Young Male: Possible Cocaine-Induced Vasospasm?
Year: 2007
Type: article
Abstract: 5th Year Medicine• When taking a history of chest pain always enquire about smoking status (pack years), presence/absence of diabetes mellitus, hypercholesterolaemia, hypertension, and whether there is a previous history of cardiac disease • In any pain history enquire about: site, onset, character, radiation, associated features, timing, relieving/aggravating factors and severity • When a patient presents with chest pain an ECG, a chest x-ray and cardiac troponins must be ordered • Always consider the possibility of cocaine use in a young patient presenting with chest pain in the absence of risk factors regardless of professional or social status CLINICAL POINTS TSMJ Vol 8 2007Patient X, a 22 year old Caucasian male presented to St James Hospital (SJH), Dublin complaining of `unbearable` central chest pain that began 1 day prior to presentation.History of The Presenting Complaint: X described a central, retrosternal pain that was constant, dull and crushing in character with a superimposed, intermittent and stabbing element.The pain began 1 day prior to presentation.It radiated to the upper pectoral region, but not to the jaw or left arm.There was no associated nausea, sweating or vomiting.The pain was aggravated by inspiration and movement, and was not relieved by simple analgesia.X graded the pain as 7/10 but graded the intermittent, stabbing element as 10/10.X denied any previous episodes of similar chest pain.After much initial denial, X eventually admitted to cocaine use on the evening prior to the onset of pain.Following physical exertion on the following afternoon, he developed the chest pain.He thought the pain would resolve spontaneously but when it failed to do so he became concerned and attended the emergency department at SJH.Past Medical History: X has no previous medical history of note and has had no prior admissions to hospital.Past Surgical History: X has no surgical history of note.Medications: X does not take medications regularly and he has no known drug allergies.
Source: Trinity Student Medical Journal
Authors: Darren Porter, Th Year Medicine
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W3159119610