N.Т. Vatutin1, 2, G.G. Taradin1, 2, О.I. Stolika2, V.B. Kostogryz2, N.А. Glinskaya2, А.V. Dmitriev2
1Department of Hospital Therapy, Donetsk National Medical University named after M. Gorky, Donetsk, Ukraine/DPR
2Department of Emergency Cardiac Care and Surgery, Institute of Urgent and Reconstructive Surgery named after V.K. Gusak, Donetsk, Ukraine/DPR
For correspondence: Gennadiy G. Taradin — PhD in Med, Ass. Prof., Department of Hospital Therapy, Donetsk National Medical University named after M. Gorky, High Senior Officer of Department of Emergency Cardiac Care and Surgery, Institute of Urgent and Reconstructive Surgery named after V.K. Gusak; e-mail: email@example.com
For citation: Vatutin NТ, Taradin GG, Stolika ОI, Kostogryz VB, Glinskaya NА, Dmitriev АV. About Atypical Localization of the Pain in Myocardial Ischemia. Intensive Care Herald. 2016;3:70–75.
Introduction. The pain syndrome is leading clinical manifestation of angina pectoris and myocardial infarction. The pain syndrome is characterized by as rule pressing and constricting pains which are located predominantly in retrosternal area or in the left side of the chest.
Clinical case. The presented clinical case describes a clinical situation when a patient had initially been complaining of pungent pains in 3rd, 4th, and 5th fingers of the left arm occurring in exercise and rest. In consultation we suspected ischemic genesis of these pains on basis of a rapid reaction to molsidomine and detection of typical for ischemia electrocardiographic (ECG) and echocardiographic changes. The patient underwent contrast coronary angiography which allowed visualizing critical stenosis of the left anterior interventricular branch of left coronary artery. Further we performed balloon angioplasty of the stenotic part and as a result the artery lumen was enlarged. The coronary stenting of the affected coronary segment was accomplished with complete restoration of the artery lumen. No abnormalities on ECG recorded in rest, exercise (treadmill test) and Holter monitoring were revealed in the post-operation period.
Conclusion. Given ischemic heart disease and, as a part, acute coronary syndrome may manifest with pains of various locations and radiations, the general practitioners and cardiologic department doctors should pay special attention to all cases accompanying by painful sensations of atypical localization that would dramatically influence on the disease course and outcome of patients.
Keywords: ischemic heart disease, acute coronary syndrome, diagnostics, pain syndrome, localization, radiation, percutaneous coronary intervention
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