A Not so Obvious Cause of Chest Pain: Pulmonary Hypertension

      A 63-year-old man was clearly a candidate for coronary artery disease, but comprehensive imaging studies led to an unexpected diagnosis. The patient presented with a 3-month history of oppressive exercise-induced chest pain and associated shortness of breath. He was a heavy smoker with hypertension and hypercholesterolemia.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Go A.S.
        • Mozaffarian D.
        • Roger V.L.
        • et al.
        • American Heart Association Statistics Committee and Stroke Statistics Subcommittee
        Heart disease and stroke statistics—2013 update. A report from the American Heart Association.
        Circulation. 2013; 127: e6-e245
        • Galiè N.
        • Torbicki A.
        • Barst R.
        • et al.
        • Task Force
        Guidelines on diagnosis and treatment of pulmonary arterial hypertension. The Task Force on Diagnosis and Treatment of Pulmonary Arterial Hypertension of the European Society of Cardiology.
        Eur Heart J. 2004; 25: 2243-2278
        • Mc Laughlin V.V.
        • Archer S.L.
        • Badesch D.B.
        • et al.
        • American College of Cardiology Foundation Task Force on Expert Consensus Documents
        • American Heart Association
        • American College of Chest Physicians
        • American Thoracic Society, Inc
        • Pulmonary Hypertension Association
        ACCF/AHA 2009 expert consensus document on pulmonary hypertension: a report of the American College of Cardiology Foundation Task Force on Expert Consensus Documents and the American Heart Association developed in collaboration with the American College of Chest Physicians; American Thoracic Society, Inc; and the Pulmonary Hypertension Association.
        J Am Coll Cardiol. 2009; 53: 1573-1619
        • van Wolferen S.A.
        • Marcus J.T.
        • Westerhof
        • et al.
        Right coronary artery flow impairment in patients with pulmonary hypertension.
        Eur Heart J. 2008; 29: 120-127
        • Ryerson C.J.
        • Nayar S.
        • Swiston J.R.
        • Sin D.D.
        Pharmacotherapy in pulmonary arterial hypertension: a systematic review and meta-analysis.
        Respir Res. 2010; 11: 12
        • Cohen H.A.
        • Baird M.G.
        • Rouleau J.R.
        • et al.
        Thallium 201 myocardial imaging in patients with pulmonary hypertension.
        Circulation. 1976; 54: 790-795
        • Nishijima K.
        • Miyahara Y.
        • Furukawa K.
        • Matsushita T.
        • Kohno S.
        Simultaneous assessment of right ventricular function and hypertrophy by Tc-99m MIBI.
        Clin Nucl Med. 1999; 24: 151-155
        • Aepfelbacher F.C.
        • Yeon S.B.
        • Ho K.K.
        • Parker J.A.
        • Danias P.G.
        ECG-gated 99mTc single-photon emission CT for assessment of right ventricular structure and function: is the information provided similar to echocardiography?.
        Chest. 2003; 124: 227-232

      Linked Article