Skip to main content

Main menu

  • Home
  • Current issue
  • Past issues
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Peer reviewer login
  • Journal club
  • Alerts
  • Subscriptions
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

User menu

  • Log in
  • Subscribe
  • Contact Us
  • My Cart

Search

  • Advanced search
  • ERS Publications
    • European Respiratory Journal
    • ERJ Open Research
    • European Respiratory Review
    • Breathe
    • ERS Books
    • ERS publications home

Login

European Respiratory Society

Advanced Search

  • Home
  • Current issue
  • Past issues
  • Authors/reviewers
    • Instructions for authors
    • Submit a manuscript
    • Peer reviewer login
  • Journal club
  • Alerts
  • Subscriptions

An adolescent with chest pain

Gwenda Vleeshouwers, Roy T. M. Sprooten, Gernot G. U. Rohde
Breathe 2013 9: 309-316; DOI: 10.1183/20734735.044112
Gwenda Vleeshouwers
Dept of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: gwendavleeshouwers@mumc.nl
Roy T. M. Sprooten
Dept of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Gernot G. U. Rohde
Dept of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • PDF
Loading

Figures

  • Tables
  • Figure 1
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 1

    Chest radiograph showing slightly increased density parahilar right (a) and dorsobasal density (b).

  • Figure 2
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 2

    CT images. a) Cavitation left upper lobe, superior lingula and pulmonary infiltrates left lower lobe, superior segment, b) pulmonary infiltration with pleural effusion, c) pulmonary infiltrates, d) right-sided thrombosis of the internal jugular vein (land some cervical lymphadenopathy).

  • Figure 3
    • Download figure
    • Open in new tab
    • Download powerpoint
    Figure 3

    Thrombosis of the internal jugular vein. On ultrasound, reactive lymph nodes were seen, but these are not visible here. In case of thrombosis, no vein is visible in the region in which you would expect a vein.

Tables

  • Figures
  • Table 1 Causes of chest pain
    LocationDifferential diagnosisPrevalence# % [2]
    PulmonaryPneumonia¶/tracheabronchitis5
    Pleuritis¶
    Pulmonary embolus¶
    Pneumothorax¶
    CardiovascularMyocarditis/pericarditis¶16
    Cardiac ischaemia
    Aortic dissection
    Vasculitis
    Chest wall/orthopaedicMyalgia/cramps36
    Fracture
    Artritis/arthrosis
    Costochondritis/bursitis
    Neuropathic pain
    Cervical/thoracic disc disease
    AbdominalReflux/oesophagitis or oesophageal dysmotility19
    Peptic ulcer
    Diafragm spasm
    Cholecystitis/choledocholithiasis
    Pancreatitis
    Nefrolithiasis
    MiscellaneousAutoimmune diseaseMiscellaneous 16; psychiatric 8
    Malignancy
    Mediastinitis/mediastinal emphysema
    Somatoform disorders
    Anxiety disorders
    Intoxications (e.g. cocaine)
    • Data from [1, 2]. #: non-emergent chest-pain in primary care. ¶: Differential diagnoses most likely in this case.

  • Table 2 Blood results
    Blood component
    Haemoglobin8.6 mmol·L-1 (13.76 g·dL−1)
    White blood cells15.26109·L-1 (15200·mm−3)
     Band forms %13
     Neutrophils %77
     Lymfocyten %8
     Monocytes %1
     Eosinophils %0.62
    D-dimers ng·mL−11011
    D-dimers ng·mL−1239
    D-dimers ng·mL−177
    • Data from [3–5].

  • Table 3 Causes of increased plasma levels of fibrin D-dimer
    CausesExamples
    Arterial or venous thromboembolic diseaseStroke, myocardial infarction, DVT, pulmonary embolism
    Disseminated intravascular coagulation or infectionCan be seen in sepsis, malignancy and obstetric mishaps.
    Normal pregnancy or (pre)eclampsia
    Surgery or trauma
    Renal diseaseNephrotic syndrome, renal failure
    Liver diseaseDue to decreased clearance
    Malignancy
    • Data from [3–5].

  • Table 4 Causes of cavitating lung lesions
    CauseExamples
    InfectionBacteria e.g. Actinomyces spp., Nocardia spp., Mycobacterium spp.; Fungi e.g. Aspergillus spp., Cryptococcus spp., pneumocystosis; Parasites e.g. Echinococcus spp.
     Pneumonia
     Lung abscess
     Septic (metastatic) embolism
    Autoimmune diseaseGranulomatosis with polyangiitis
    Sarcoidosis
    Rheumatoid arthritis
    Ankylosing spondylitis
    Systemic lupus erythematosus
    MalignancyPrimary lung cancer, mostly squamous cell
    Lymphoma
    Lung metastasis
    Kaposi’s sarcoma
    Congenital abnormality/acquired lung diseaseBronchogenic cyst
    Histiocytosis X (langerhans histiocytosis)
    Lymphangioleiomyomatosis
    Vascular diseasePulmonary embolism (septic or aseptic)
    BOOP/COPDue to e.g. medication, radiotherapy or autoimmune disease
    • Data from [6]. BOOP: bronchiolitis obliterans organising pneumonia; COP: cryptogenic organising pneumonitis.

PreviousNext
Back to top
Vol 9 Issue 4 Table of Contents
Breathe: 9 (4)
  • Table of Contents
  • Index by author
Email

Thank you for your interest in spreading the word on European Respiratory Society .

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
An adolescent with chest pain
(Your Name) has sent you a message from European Respiratory Society
(Your Name) thought you would like to see the European Respiratory Society web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Print
Citation Tools
An adolescent with chest pain
Gwenda Vleeshouwers, Roy T. M. Sprooten, Gernot G. U. Rohde
Breathe Jun 2013, 9 (4) 309-316; DOI: 10.1183/20734735.044112

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
An adolescent with chest pain
Gwenda Vleeshouwers, Roy T. M. Sprooten, Gernot G. U. Rohde
Breathe Jun 2013, 9 (4) 309-316; DOI: 10.1183/20734735.044112
Reddit logo Technorati logo Twitter logo Connotea logo Facebook logo Mendeley logo
Full Text (PDF)

Jump To

  • Article
    • Discussion
    • Conclusion
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • PDF

Subjects

  • Pulmonary pharmacology and therapeutics
  • Respiratory clinical practice
  • Tweet Widget
  • Facebook Like
  • Google Plus One

More in this TOC Section

  • Lung cancer screening by volume CT
  • In pursuit of the primary
  • A rare complication in a case of nonsmall cell lung carcinoma
Show more Expert opinion

Related Articles

Navigate

  • Home
  • Current issue
  • Archive

About Breathe

  • Journal information
  • Editorial board
  • Press
  • Permissions and reprints
  • Advertising

The European Respiratory Society

  • Society home
  • myERS
  • Privacy policy
  • Accessibility

ERS publications

  • European Respiratory Journal
  • ERJ Open Research
  • European Respiratory Review
  • Breathe
  • ERS books online
  • ERS Bookshop

Help

  • Feedback

For authors

  • Intructions for authors
  • Publication ethics and malpractice
  • Submit a manuscript

For readers

  • Alerts
  • Subjects
  • RSS

Subscriptions

  • Accessing the ERS publications

Contact us

European Respiratory Society
442 Glossop Road
Sheffield S10 2PX
United Kingdom
Tel: +44 114 2672860
Email: journals@ersnet.org

ISSN

Print ISSN: 1810-6838
Online ISSN: 2073-4735

Copyright © 2023 by the European Respiratory Society