Advertisement
Mayo Clinic Proceedings Home
MCP Digital Health Home

38-Year-Old Woman With Chest Pain

      A 38-year-old woman presented to the emergency department (ED) with abrupt onset left-sided chest pain. She described the pain as intense, sharp, and radiating to her left arm, with associated nausea and diaphoresis. Her medical history was notable for fibromuscular dysplasia of the renal arteries complicated by renovascular hypertension status post angioplasty, posttraumatic stress disorder, and former tobacco use. Her daily home medications included aspirin, hydroxyzine, lisinopril, sertraline, and trazodone.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Mayo Clinic Proceedings
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • von Kodolitsch Y.
        • Schwartz A.G.
        • Nienaber C.A.
        Clinical prediction of acute aortic dissection.
        Arch Intern Med. 2000; 160: 2977-2982https://doi.org/10.1001/archinte.160.19.2977
        • Wolf S.J.
        • McCubbin T.R.
        • Feldhaus K.M.
        • Faragher J.P.
        • Adcock D.M.
        Prospective validation of Wells criteria in the evaluation of patients with suspected pulmonary embolism.
        Ann Emerg Med. 2004; 44: 503-510https://doi.org/10.1016/j.annemergmed.2004.04.002
        • Sahn S.A.
        • Heffner J.E.
        Spontaneous pneumothorax.
        N Engl J Med. 2000; 342: 868-874https://doi.org/10.1056/NEJM200003233421207
        • Rodriguez Ziccardi M.
        • Hatcher J.D.
        Prinzmetal angina.
        in: StatPearls. StatPearls Publishing, 2021
        • Antman E.M.
        • Anbe D.T.
        • Armstrong P.W.
        • et al.
        • American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction)
        ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction—executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1999 Guidelines for the Management of Patients With Acute Myocardial Infarction).
        Circulation. 2004; 110 (Published correction appears in Circulation. 2005;111(15):2013. https://doi.org/10.1161/01.CIR.0000134791.68010.FA): 588-636
        • Wiest D.
        Esmolol: a review of its therapeutic efficacy and pharmacokinetic characteristics.
        Clin Pharmacokinet. 1995; 28: 190-202https://doi.org/10.2165/00003088-199528030-00002
        • Palmer R.F.
        • Lasseter K.C.
        Drug therapy: sodium nitroprusside.
        N Engl J Med. 1975; 292: 294-297https://doi.org/10.1056/NEJM197502062920606
        • Meine T.J.
        • Roe M.T.
        • Chen A.Y.
        • et al.
        CRUSADE Investigators. Association of intravenous morphine use and outcomes in acute coronary syndromes: results from the CRUSADE Quality Improvement Initiative.
        Am Heart J. 2005; 149: 1043-1049https://doi.org/10.1016/j.ahj.2005.02.010
        • Chevalier P.
        • Dacosta A.
        • Defaye P.
        • et al.
        Arrhythmic cardiac arrest due to isolated coronary artery spasm: long-term outcome of seven resuscitated patients.
        J Am Coll Cardiol. 1998; 31: 57-61https://doi.org/10.1016/s0735-1097(97)00442-7
        • Ong P.
        • Athanasiadis A.
        • Borgulya G.
        • Voehringer M.
        • Sechtem U.
        3-Year follow-up of patients with coronary artery spasm as cause of acute coronary syndrome: the CASPAR (Coronary Artery Spasm in Patients With Acute Coronary Syndrome) study follow-up.
        J Am Coll Cardiol. 2011; 57: 147-152https://doi.org/10.1016/j.jacc.2010.08.626
        • Onaka H.
        • Hirota Y.
        • Shimada S.
        • et al.
        Prognostic significance of the pattern of multivessel spasm in patients with variant angina.
        Jpn Circ J. 1999; 63: 509-513https://doi.org/10.1253/jcj.63.509
        • Corcos T.
        • David P.R.
        • Bourassa M.G.
        • et al.
        Percutaneous transluminal coronary angioplasty for the treatment of variant angina.
        J Am Coll Cardiol. 1985; 5: 1046-1054https://doi.org/10.1016/s0735-1097(85)80004-8
      CORRECT ANSWERS: 1. e. 2. d. 3. a. 4. b. 5. c