RT Journal Article
SR Electronic
T1 Sometimes (What Seems to Be) A Heart Attack Is (Really) A Pain In The Neck
JF The Journal of the American Board of Family Practice
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 74
OP 77
DO 10.3122/jabfm.17.1.74
VO 17
IS 1
A1 Mork, Anthony A.
A1 Haufe, Scott M. W.
A1 Yancey, William B.
YR 2004
UL http://www.jabfm.org/content/17/1/74.abstract
AB 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.