title: Chest pain and an abnormal chest X-ray--a case report.
abstract: Chest pain is a common symptom amongst patients presenting to the acute medical unit, and presents a diagnostic challenge. We present the case of a previously healthy 65 year old year old gentleman with chest pain and subsequent vomiting, treated initially as an acute coronary syndrome, despite normal ECG and troponin. Chest radiograph revealed left basal consolidation with an effusion, suggesting pneumonia. The absence of symptoms of respiratory infection along with a normal C-reactive protein level led to further investigation with CT. This revealed evidence of oesophageal rupture (Boerhaave's syndrome). Despite early surgical intervention our patient suffered a number of complications and continues his recovery in hospital three months post presentation.
authors.affiliation: Department of Intensive Care, Royal Surrey County Hospital, Egerton Road, Guildford, GU2 7XX.
authors.forename: N
authors.initials: N
authors.lastname: Smallwood
authors.forename: S
authors.initials: S
authors.lastname: Perrio
mesh_terms: D000368:Aged; D002097:C-Reactive Protein; D002637:Chest Pain / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D003937:Diagnosis, Differential; D004939:Esophageal Perforation / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D004947:Esophagus / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D010996:Pleural Effusion / Q000175:diagnosis* / Q000209:etiology; D013902:Radiography, Thoracic / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014839:Vomiting / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D004935:Esophageal Diseases; D012422:Rupture, Spontaneous; D000072663:Spontaneous Perforation
chemical_list: D002097:C-Reactive Protein