Published 21 July 2008, doi:10.1136/bmj.a688
Cite this as: BMJ 2008;337:a688

Practice

Rational Imaging

Investigating severe interscapular pain

Ali A Haydar, radiologist1, Gareth Morgan-Hughes, cardiologist2, Carl Roobottom, radiologist1

1 Peninsula Radiology Academy, Plymouth PL6 5WR, 2 Cardiology Department, Derriford Hospital, Plymouth

Correspondence to: A Haydar drahaydar@hotmail.com

This article explores the radiological investigations for identifying the cause of severe interscapular pain, focusing on how to exclude acute myocardial infarction, aortic dissection, and pulmonary embolism

The first 150 words of the full text of this article appear below.

A 52 year old woman presented with a sudden onset (two hour history) of severe interscapular burning pain associated with shortness of breath. Her medical history was unremarkable except for a strong family history of coronary heart disease.

Examination was normal apart from a blood pressure of 150/80 mm Hg and heart rate of 110 beats/min. The respiratory rate was 14 breaths/min, and the patient was afebrile with otherwise normal cardiorespiratory examination. Chest radiography showed borderline widened mediastinum and upper lobe venous congestion. Electrocardiography showed non-specific changes in the T waves. Blood gas analysis showed the patient to be hypoxic (PaO2 = 8 kPa (normal 8-14 kPa)), with no evidence of carbon dioxide retention. Her full blood count and biochemical profile were normal except for mildly raised C reactive protein and positive D-dimers. Baseline level of troponin I was <0.01 ng/ml.

Chest pain was partially relieved by glyceril trinitrate spray; . . . [Full text of this article]


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

Limitations of multidetector computed tomography (MDCT)
Edward D Nicol and James Stirrup
BMJ 2008 337: a1402. [Extract] [Full Text]

This article has been cited by other articles:

  • Nicol, E. D, Stirrup, J. (2008). Limitations of multidetector computed tomography (MDCT). BMJ 337: a1402-a1402 [Full text]  

Rapid Responses:

Read all Rapid Responses

"Triple Rule Out" For the Investigation of Acute Chest Pain: A Note of Caution.
Edward D Nicol, et al.
bmj.com, 18 Aug 2008 [Full text]
Rational use of imaging--comments
Mark T Harbinson
bmj.com, 26 Aug 2008 [Full text]
Access jobs at BMJ Careers
Whats new online at Student BMJ