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Typical chest pain and dyspnoea in a young man with a history of intravenous drug use
  1. Alexander Oshiro Gong,
  2. Kristen R Burton
  1. Department of Cardiovascular Medicine, LAC USC Medical Center, Los Angeles, California, USA
  1. Correspondence to Dr Alexander Oshiro Gong, Cardiovascular Medicine, LAC USC Medical Center, Los Angeles, CA 90033, USA; alexander.o.gong{at}gmail.com

http://dx.doi.org/10.1136/heartjnl-2020-317280

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    Clinical introduction

    A patient in his 30s with a history of intravenous drug use and traumatic aortic injury requiring endovascular stenting 10 years prior presents with 1 week of chest pain, dyspnoea on exertion and chills. His vitals were heart rate (HR) 108 bpm, blood pressure (BP) 136/87, temperature (T) 36.4°C, respiratory rate (RR) 27, saturating 97% on 3 L nasal cannula. There was a loud S2 on cardiac auscultation, but the rest of his physical exam was unremarkable. Electrocardiogram (EKG) showed sinus tachycardia with T wave inversions in V2–V4. Chest X-ray demonstrated normal cardiac silhouette and was unremarkable for pulmonary pathology. CT pulmonary angiography showed a linear saddle embolus extending across the branch point of the right and left main pulmonary arteries (PAs) …

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    Footnotes

    • Contributors AOG is the first author of this submitted manuscript and KRB is the second author.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.