Khan Mueen Ullah, Ahmed Imtiaz
Department of Anaesthesia and Intensive Care, Aga Khan University, Karachi.
J Pak Med Assoc. 2007 Sep;57(9):470-2.
Acute chest pain is a common presentation in emergency. After clinical assessment undiagnosed chest pain can become a difficult problem. Sympathetically mediated chest pain is a rare presentation, as it is similar to that of secondary hyperalgesia in the intact skin surrounding an injury site. We are reporting a case of a 62 years old man who presented with atypical chest pain four months after coronary artery bypass grafting (CABG). On investigation no new change was noticed than previous evaluation. On chronic pain assessment he was having hyperalgesia to light touch in addition to the spontaneous chest pain. He was treated as a case of sympathetically mediated chest pain, pain modulators, analgesics and Stellate ganglion block. Patient responded dramatically to Stellate ganglion block and returned to work within two weeks time. This case illustrated the importance of early diagnosis of sympathetically mediated chest pain and role of Stellate ganglion block.
急性胸痛是急诊科常见的症状。经过临床评估后，未确诊的胸痛可能会成为一个难题。交感神经介导的胸痛是一种罕见的表现，因为它与损伤部位周围完整皮肤中的继发性痛觉过敏相似。我们报告一例62岁男性患者，在冠状动脉旁路移植术（CABG）四个月后出现非典型胸痛。经检查，与之前的评估相比未发现新的变化。在慢性疼痛评估中，除了自发性胸痛外，他对轻触也有痛觉过敏。他被作为交感神经介导的胸痛病例进行治疗，使用了疼痛调节剂、镇痛药和星状神经节阻滞。患者对星状神经节阻滞反应显著，并在两周内恢复工作。该病例说明了交感神经介导的胸痛早期诊断的重要性以及星状神经节阻滞的作用。
