PDF(Pubmed)
Abstract：
When a clinician, especially one who is specialized in primary care is faced with presenting complaints of deep, sharp, anterior chest pain, the most common differential diagnoses include cardiac and gastrointestinal pain. Musculoskeletal pain is thought of less frequently as a possible root cause. In this case report, we describe the clinical journey of a female athlete who presented with complaints of burning anterior chest pain. Her sternalis syndrome pain was first misdiagnosed as pain of cardiac origin, resulting in pacemaker placement into the patient\'s chest. The pain continued, and the same musculoskeletal pain was then presumed to be of gastrointestinal origin due to a previous history of gastroesophageal reflux disease (GERD). As a result of this misidentification, the patient underwent an unnecessary esophageal surgical procedure. Here, we identify the origins of sternalis syndrome pain, what other conditions the pain may be confused with, and how clinicians should not be quick to exclude musculoskeletal pain from a differential diagnosis of acute chest pain. We discuss effective treatments for sternalis syndrome and shed light on this less common cause of anterior chest pain to promote more accurate diagnosis and avoidance of unnecessary surgical interventions.
摘要：
当临床医生，特别是一个专门从事初级保健的人面临着深刻的抱怨，锋利,前胸痛,最常见的鉴别诊断包括心脏疼痛和胃肠道疼痛。肌肉骨骼疼痛被认为是可能的根本原因，频率较低。在这个案例报告中,我们描述了一名女性运动员的临床旅程，她主诉烧灼的前胸痛。她的胸骨综合征疼痛最初被误诊为心脏疼痛，导致起搏器植入患者的胸部。疼痛继续，由于以前的胃食管反流病（GERD）病史，因此推测相同的肌肉骨骼疼痛是胃肠道引起的。由于这种错误识别，患者接受了不必要的食管外科手术.这里,我们确定了胸骨综合征疼痛的起源，疼痛可能与其他什么情况混淆，以及临床医生不应该迅速将肌肉骨骼疼痛排除在急性胸痛的鉴别诊断之外。我们讨论了胸骨综合征的有效治疗方法，并阐明了这种不太常见的前胸痛原因，以促进更准确的诊断并避免不必要的手术干预。
