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Rational Pharmacotherapy in Cardiology

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Thoracalgia in a Patient with Determined Coronary Heart Disease. Is there Always a Relapse of Angina Pectoris?

https://doi.org/10.20996/1819-6446-2020-02-05

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Abstract

This article presents a clinical case of a 62-year-old man with a long history of coronary heart disease and smoking, whose main complaint upon admission to the hospital was voice hoarseness and atypical pain syndrome in the chest. During a preliminary medical examination, attention was paid to the clinical picture, atypical for a coronary heart disease – voice hoarseness was identified as a manifestation of the recurrent nerve compression, or cardio-vocal syndrome. Given the lack of connection between the chest pain and physical exertion, a high index of a smoking person as well as signs of the recurrent nerve compression syndrome, a multi-spiral computer tomography with contrasting of the chest organs was performed (in line with official recommendations of the Russian Associations of Oncologists and Otolaryngologists). The results revealed a proliferative lesion of the mediastinum and multiple focal lesions of both lungs. A subsequent thoracoscopy and biopsy confirmed the mediastinal form of a lung cancer. Promptly initiated poly-chemotherapy allowed stabilizing the patient’s condition and significantly improving his prospects. In this context, the article discusses the complexity of a timely diagnosis of a primary lung cancer and emphasizes the need to focus on specific and unique features of the disease course as well as on a broader clinical picture. Tactics of a multidisciplinary approach allows making a diagnosis in a timely manner, significantly improving the effectiveness of therapy and patient’s survival prognosis.

About the Authors

O. M. Drapkina
National Medical Research Center for Preventive Medicine
Russian Federation

Oxana M. Drapkina – MD, PhD, Professor, Corresponding Member of the Russian Academy of Sciences, Director, National Medical Research Center for Therapy and Preventive Medicine

Petroverigsky per. 10, Moscow, 101990





A. A. Zeynapur
National Medical Research Center for Preventive Medicine
Russian Federation

Aida A. Zeynapur – MD, PhD, Head of Admission Department

Petroverigsky per. 10, Moscow, 101990



A. S. Klevina
National Medical Research Center for Preventive Medicine
Russian Federation

Alina S. Klevina – MD, Cardiologist, Admission Department

Petroverigsky per. 10, Moscow, 101990





O. B. Vasileva
National Medical Research Center for Preventive Medicine
Russian Federation

Olga B. Vasileva – MD, Cardiologist, Admission Department

Petroverigsky per. 10, Moscow, 101990



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For citation:


Drapkina O.M., Zeynapur A.A., Klevina A.S., Vasileva O.B. Thoracalgia in a Patient with Determined Coronary Heart Disease. Is there Always a Relapse of Angina Pectoris? Rational Pharmacotherapy in Cardiology. 2020;16(1):46-50. (In Russ.) https://doi.org/10.20996/1819-6446-2020-02-05

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ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)