title: Chest Pain: The Need to Consider Less Frequent Diagnosis.
abstract: Chest pain is one of the most frequent patient's complaints. The commonest underlying causes are well known, but, sometimes, in some clinical scenarios, it is necessary to consider other diagnoses. We report a case of a 68-year-old Caucasian male, chronically hypertensive, who complained of recurrent episodes of chest pain and fever with elevated acute phase reactants. The first investigation was negative for some of the most likely diagnosis and he quickly improved with anti-inflammatory drugs. Over a few months, his symptoms continued to recur periodically, his hypertension was aggravated, and he developed headaches and lower limbs claudication. After a temporal artery biopsy that was negative for vasculitis, he underwent a positron emission tomography suggestive of Takayasu Arteritis. Takayasu Arteritis is a rare chronic granulomatous vasculitis of the aorta and its first-order branches affecting mostly females up to 50 years old. Chest pain is experienced by >40% of the patients and results from the inflammation of the aorta, pulmonary artery, or coronaries.
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal.
authors.forename: Pedro
authors.identifier: 0000-0001-8281-0952
authors.initials: P
authors.lastname: Magalhães
authors.affiliation: Serviço de Medicina Interna, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal.
authors.forename: Anabela
authors.initials: A
authors.lastname: Morais
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal.
authors.forename: Sofia
authors.initials: S
authors.lastname: Carvalho
authors.affiliation: Serviço de Medicina Interna, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Cunha
authors.affiliation: Serviço de Medicina Interna, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal.
authors.forename: Ana R
authors.initials: AR
authors.lastname: Lima
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal.
authors.forename: J Ilídio
authors.initials: JI
authors.lastname: Moreira
authors.affiliation: Serviço de Medicina Interna, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal.
authors.forename: Trigo
authors.initials: T
authors.lastname: Faria