• The Korean Journal of Emergency Medical Services
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• v.25 no.1
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• pp.243-249
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• 2021

A decrease in coronary blood flow leads to an imbalance between the supply of oxygen to the myocardium and its demand, and reversible or irreversible damage to the myocardium could occur depending on the severity of the resultant ischemia and the duration of the imbalance. This imbalance results in a cascade of ischemic reactions in the following order: metabolic abnormalities, diastolic dysfunction, systolic dysfunction, and electrocardiogram changes. Variant angina is caused by the closure of the coronary artery due to reversible coronary artery spasm, resulting in myocardial ischemia and subsequent chest pain as a clinical symptom. Variant angina may be observed as ST segment elevation in electrocardiogram measured when present in chest pain. However, 12-lead electrocardiogram performed after the patient's chest pain resolves does not help in the diagnosis. Since the duration of chest pain appears to be <15 minutes, it is important to perform the 12-lead electrocardiogram when clinical symptoms are present. If nitroglycerin is administered without performing 12-lead electrocardiogram by 119 pre-hospital paramedics, the chest pain would be resolved, making it impossible to identify changes in the ST segment. Before administration of nitroglycerin, changes in the ST segment must be recorded by performing 12-lead electrocardiogram.

• Journal of Yeungnam Medical Science
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• v.39 no.3
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• pp.190-199
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• 2022

Ultrasound-guided injection is useful for managing thoracic spine and chest wall pain. With ultrasound, pain physicians perform the injection with real-time viewing of major structures, such as the pleura, vasculature, and nerves. Therefore, the ultrasound-guided injection procedure not only prevents procedure-related adverse events but also increases the accuracy of the procedure. Here, ultrasound-guided interventions that could be applied for thoracic spine and chest wall pain were described. We presented ultrasound-guided thoracic facet joint and costotransverse joint injections and thoracic paravertebral, intercostal nerve, erector spinae plane, and pectoralis and serratus plane blocks. The indication, anatomy, Sonoanatomy, and technique for each procedure were also described. We believe that our article is helpful for clinicians to conduct ultrasound-guided injections for controlling thoracic spine and chest wall pain precisely and safely.

• The Korean Journal of Pain
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• v.5 no.1
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• pp.63-68
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• 1992

One hundred and four patients who complained of chest pain or back pain in the region between scapular were studied. In most cases, anatomical location of pain was in the rhomboid or serratus anterior muscle. Hyperactivity of dorsal scapular nerve or long thoracic nerve which innervate those muscles was thought to be responsible for the pain. The hyperactivity of the nerves may be due to the spasm of the scalenus medius muscle which the nerves meet during their course to the rhomboid or serratus anterior muscles. Therefore, spasmolytic treatment including trigger point injection, physical therapy, laser therapy, or NSAIDs may be effective for the treatment of chest pain or back pain.

• Journal of Yeungnam Medical Science
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• v.35 no.1
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• pp.104-108
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• 2018

Syncope is defined as a transient loss of consciousness and postural tone, characterized by rapid onset, short duration, and spontaneous recovery. Stellate ganglion block (SGB) is a nerve block method that is used for treatment of neuropathic pain in the head, neck and upper extremities, especially trigeminal neuralgia, postherpetic neuralgia and complex regional pain syndrome. SGB can modulate and stabilize the sympathetic nervous system, which prevents it from overexcitation and improves symptoms of syncope. The authors report a patient who was treated for pain and edema of both upper extremities with SGB, then showed improvement in recurrent syncope followed by chest pain and overall quality of life.

• The Korean Journal of Pain
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• v.11 no.2
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• pp.335-337
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• 1998

This is a case report of a 69 years old non-smoking male patient with a lung cancer who presented with postherpetic neuralgia on the left T2, 3 and 4 dermatomes. This pain was aggravated in supine position. The patient did not have any other symtoms or signs to suggest the possibility of a lung cancer. Patient's baseline laboratory findings were essentially normal. Routine chest X-ray revealed hazy densities in the left apex. Further evaluation with chest CT confirmed the presence of a lung cancer corresponding to the densities seen on the chest X-ray.

• Journal of Korean Critical Care Nursing
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• v.1 no.1
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• pp.33-45
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• 2008

Purpose: Patients who underwent a coronary artery bypass graft surgery(CABG) experienced the unpleasant emotions and discomfort when their chest tube was removed. The purpose of this study was to evaluate the effects of cold therapy on pain related to chest tube removal(CTR) in CABG patients. Methods: Fifty adult patients undergoing CABG were recruited in a prospective, double blinded study. Subjects were divided into the experimental group and the control group considering their sex and age. The pretest data were obtained 20 minutes before CTR. Patients in the experimental group, received cold therapy for 10 minutes before CTR. Pain sense and intensity were determined immediately after CTR and at 10 minutes after CTR. Results: The total score of pain sense immediately after CTR of the experimental group was significantly lower than that of the control group(t=-3.703, p=.003). And scores of pain intensity immediately after CTR in the experimental group were significantly lower than that of the control group(t=-3.073, p=.001). But, there was no significant difference in the score of pain intensity 10 minutes after CTR between the experimental and the control group(t=1.759, p=.085). Conclusion: The cold therapy would be recommended as an effective and nonpharmacologic nursing intervention for relieving pain in patients undergoing CTR.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.449-451
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• 2023

We report a case of chest wall resection for painful chest wall nonunion, 5 years after traumatic flail chest and a first attempt at surgical treatment. The decision was made to perform surgery again after 2 years of unsuccessful well-conducted analgesic treatment. During surgery, we found the same sites of pseudarthrosis and decided to perform parietectomy of the fifth, sixth, and seventh ribs. A Gore-Tex patch was used to bridge the gap created by the resection. In immediate postoperative care, the patient's pain was quickly and sufficiently eased by stage 1 and 2 pain killers. The results of bone samples taken from the pseudarthrosis sites all found Propionibacterium acnes. Five months after surgery, the patient had considerable improvement in pain sensations. Computed tomography showed healing of ribs, the plate in place, and no sign of complications.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1248-1252
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• 2003

Purpose : Chest pain in the pediatric population is not rare and mostly benign. Causes of chest pain are diverse, and differential diagnosis is not easy. Chest pain in children is less likely to be cardiac in origin. Furthermore, chest pain in the pediatric population is rarely associated with life-threatening disease. This study was designed to evaluate children with chest pain and the usefulness of several diagnostic examinations. Methods : Between March 2001 and August 2002, 33 patients(15 boys and 18 girls, aged four to 15 years) presented with chronic chest pain. The records of these patients were reviewed. Chest radiography and electrocardiogram were performed in all patients. Cardiologic and gastrointestinal evaluations were carried out when considered necessary. Results : Chest pain was most common in the age group of 10 to 12 years old, and the four to six years old group. The most common diagnostic findings of chest pain were idiopathic(15 cases, 45.5 %), heart disease(9 cases, 27.3%), upper gastrointestinal disease(6 cases, 18.2%), respiratory disease (2 cases, 6%) and trauma(1 case, 3%). In children with abnormal results of cardiologic evaluation, these findings are not major etiologic categories of chest pain. Through history taking and physical examinations, six cases were evaluated concerning gastrointestinal disease and all of them showed gastrointestinal diseases(esophagitis, gastroesophageal reflux disease, nodular gastritis and chronic superficial gastritis). Conclusion : Chest pain is usually benign in children but the possibility of cardiovascular or gastrointestinal disease is considered. Careful history taking, physical examination and proper clinical examinations are usually required to find out the rare life-threatening causes of chest pain.

• Journal of Chest Surgery
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• v.26 no.10
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• pp.812-814
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• 1993

Six patients with flail chest were performed operative stabilization with Judet`s Struts.The indications of opertive stabilization were exploratory thoracotomy or laparotomy in 4 patients, and severe chest pain due to displaced ribs which deteriorated respiratory pattern and gas exchange in 2 patients. After operation, all patients became comfortable and complained less pain.Two patients restored spontaneous breathing without ventilator therapy and 2 patients were ventilated during 4 days and 5 days, respectively.There were no morbidity and mortality related to operative stabilization.

• The Korean Journal of Pain
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• v.12 no.1
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• pp.148-151
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• 1999

This report is a case of 62-year-old man with anterior chest pain and pin pricking pain with allodynia affecting left T5 sensory dermatome for 3 months without history of vesicular skin eruption. He had a history of diabetes mellitus for 10 years and insulin therapy for recent 1 year. EKG, chest PA and rib series were normal. Serologic evaluation of IgG antibody to varicella-zoster virus was positive and was diagnosed as post herpetic neuralgia after zoster sine herpete. He was treated with left T5 nerve root block followed by thoracic epidural blockade and intercostal nerve block for 2 weeks. His VAS score decreased from 10 to 2 after 2 weeks of treatment. After 3 months, he revisited our clinic complaining right side chest pain followed by vesicular skin eruption 8 days after the onset of pain. He was treated as herpes zoster and tolerates well after 4 months.