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Case Reports in Cardiology
Volume 2016, Article ID 4294780, 5 pages
http://dx.doi.org/10.1155/2016/4294780
Case Report

Chest Pain: The Need to Consider Less Frequent Diagnosis

1Serviço de Cardiologia, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal
2Serviço de Medicina Interna, Centro Hospitalar de Trás-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal

Received 30 November 2015; Accepted 10 February 2016

Academic Editor: Tayfun Sahin

Copyright © 2016 Pedro Magalhães et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chest pain is one of the most frequent patient’s complaints. The commonest underlying causes are well known, but, sometimes, in some clinical scenarios, it is necessary to consider other diagnoses. We report a case of a 68-year-old Caucasian male, chronically hypertensive, who complained of recurrent episodes of chest pain and fever with elevated acute phase reactants. The first investigation was negative for some of the most likely diagnosis and he quickly improved with anti-inflammatory drugs. Over a few months, his symptoms continued to recur periodically, his hypertension was aggravated, and he developed headaches and lower limbs claudication. After a temporal artery biopsy that was negative for vasculitis, he underwent a positron emission tomography suggestive of Takayasu Arteritis. Takayasu Arteritis is a rare chronic granulomatous vasculitis of the aorta and its first-order branches affecting mostly females up to 50 years old. Chest pain is experienced by >40% of the patients and results from the inflammation of the aorta, pulmonary artery, or coronaries.