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CT angiography in a 45-year-old woman with atypical chest pain revealed two left anterior descending (LAD) arteries in the anterior interventricular sulcus (AIS). The longer LAD (white arrowhead in [figure 1A–D][1]) was arising from the left main coronary artery (LMCA) and was coursing up to the

A woman aged 25 years was referred to cardiology for atypical chest pain. This was described as sharp non-exertional left-sided chest pain lasting a few seconds. Vitals showed BP 122/85 and pulse 87 bpm. Cardiovascular examination revealed normal S1 and S2, an S4 and no murmurs. ECG showed normal sinus rhythm. Transthoracic echocardiography showed marked trabeculation of the apical lateral segments (figure 1). Cardiac MRI confirmed these trabeculations with no diagnostic criteria for non-compaction. Figure 1 (A) Cardiac MRI showing the …

A 45-year-old man presented in the outpatient clinic with occasional atypical chest pain. ECG was normal, and echocardiography did not reveal any wall motion abnormality. The patient was referred to us for CT angiography (CTA) to rule out coronary artery disease. The CTA, done on 192(×2)-slice

We report a 57-year-old man presenting with symptoms of sharp pricking, exertional retrosternal chest pain multiple times, each episode lasting for a few seconds. On evaluation, the ECG of the patient showed normal sinus rhythm with T wave inversions in leads V1-V3. Troponin T test was negative. Transthoracic echocardiography showed a globular mass in the interventricular septum. Cardiac MRI was suspicious of the lesion to be a hydatid cyst. Surgical excision of the lesion followed by histopathology was confirmatory of hydatid cyst.

While peripheral artery aneurysms are rarely encountered, brachial artery aneurysms are even rarer. Most of those seen are usually dissecting aneurysms of infectious, post-traumatic or iatrogenic origin; true aneurysms of the brachial artery are even more unusual.1 ,2 There may be a cause of in situ thrombosis, which might occlude vessels. The risk of limb loss can be avoided by prompt diagnosis and early surgery.3 ,4 The best therapeutic option is operative repair or closure by covered stent, although there are no uniform guidelines regarding the timing and indications of intervention. We present an interesting case of a 58-year-old man who presented with symptoms of atypical chest pain with non-specific ST-T changes in the ECG. The patient was taken up for a …

Boerhaave9s syndrome is a rare but life-threatening condition characterised by spontaneous rupture of the oesophagus. Owing to its rarity, it is often not thought about as a cause for chest pain and is often admitted under a medical ward. This can lead to a delayed diagnosis with unfavourable outcomes. A 93-year-old female presented with severe atypical chest pain that was difficult to control. Her initial baseline tests were normal but her condition deteriorated and she desaturated through the night. A repeat chest x-ray showed right basal consolidation and pneumomediastinum. A diagnosis of Boerhaave9s syndrome was made. She was unfortunately at this stage critically unwell and continued to deteriorate. She died 17 h after admission.