We Should Pay Attention to "Referred Pain" - A Case of Acute Myocardial Infarction That Masked and Delayed the Diagnosis of Esophageal Perforation.

Kotaro Noda, Nobuyuki Nosaka, Nobuhiro Hara, Takanori Yokota, Hidenobu Shigemitsu, Hideo Takahashi

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In one paragraph

Article in Internal medicine (Tokyo, Japan), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it

0cells of the map it votes in

0citing papers in PubMed

–field-weighted citation impact, top 79% of its field

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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0 citing papers in PubMed, 1 citations in OpenAlex.

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5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Kotaro NodaDepartment of Intensive Care Medicine, Japanese Red Cross Musashino Hospital, Japan.

Nobuyuki NosakaDepartment of Intensive Care Medicine, Japanese Red Cross Musashino Hospital, Japan.

Nobuhiro HaraDepartment of Cardiology, Japanese Red Cross Musashino Hospital, Japan.

Takanori YokotaDepartment of Neurology and Neurological Science, Tokyo Medical and Dental University, Japan.

Hidenobu ShigemitsuDepartment of Intensive Care Medicine, Tokyo Medical and Dental University, Japan.

Hideo TakahashiDepartment of Intensive Care Medicine, Japanese Red Cross Musashino Hospital, Japan.

Musashino Red Cross Hospital · JPTokyo Medical and Dental University · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We herein report a 93-year-old woman diagnosed with acute myocardial infarction (AMI) based on typical laboratory findings of severe chest pain accompanied by throat pain. This condition was initially interpreted as referred pain of cardiac origin. However, the patient had persistent throat pain after successful percutaneous coronary intervention. Upper esophageal perforation with life-threatening acute mediastinitis was unexpectedly identified by a further examination. Clinicians should have a high index of suspicion in cases with persistent symptoms thought to be referred pain among AMI patients, as these symptoms may not be of cardiac origin but rather a sign of another concomitant critical disease.

Indexed as

Esophageal PerforationMyocardial InfarctionAcute DiseaseAged, 80 and overChest PainFemaleHumansReferred Paindiagnosisesophageal perforationmyocardial infarctionreferred painthroat pain

Identifiers

PMID34565771

DOI10.2169/internalmedicine.7694-21

PMCPMC9107967

OpenAlexW3202797085

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LicenceCC BY-NC-ND

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.