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The Journal of the American Board of Family Practice 17:74-77 (2004)
© 2004 American Board of Family Practice

Brief Report

Sometimes (What Seems to Be) A Heart Attack Is (Really) A Pain In The Neck

Anthony A. Mork, MD, Scott M. W. Haufe, MD and William B. Yancey, MD

From Microspine, Inc., Defuniak Springs, Florida. Address correspondence to William B. Yancey, MD, 19 Buddy Street, Santa Rosa Beach, FL 32459 (e-mail: wbyancey{at}earthlink.net)

Abstract

A 31-year-old patient complained of severe crushing chest pain that radiated to his left arm and jaw. After admission to the hospital, tests revealed a normal electrocardiogram, normal treadmill, normal coronary arteriogram, and normal cardiac enzymes. However, the patient continued to have pain, which was relieved by sublingual and intravenous nitroglycerine. He was discharged from the hospital with a diagnosis of "musculoskeletal" chest pain, taking nonsteroidal anti-inflammatory drugs, muscle relaxants, and narcotics. Two weeks later, the patient returned with worsening symptoms. Cardiac work-up was again negative. Thoracic and cervical spine radiographs were ordered for possible discogenic pain. After abnormalities were found on cervical radiographs, magnetic resonance imaging (MRI) was ordered, and the patient was referred to an orthopedic surgeon. Further work-up revealed a herniated disk at C6–C7, with radicular pain. Surgery on the suspect disk totally relieved the patient’s pain.






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Copyright © 2004 by the American Board of Family Medicine.