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A middle-aged patient with lung cancer had presented to clinic complaining of generalized malaise, cough, and chestpain. Symptoms other than chestpain (malaise, cough in a cancer patient) 2. Inclusion criteria were chestpain, at least 2 serial cTnI in 24 hours, sinus rhythm , and at least 1 ECG.
On the second morning of his admission, he developed 10/10 chestpain and some diaphoresis after breakfast. The patient was given opiates which improved his chestpain to 7/10. The consulting cardiologist wrote in their note: “Could be cardiac chestpain. She is usually incredibly good at recognizing them!
This occurs most commonly in cancer (malignant pericardial effusion). Usually it is cancer of other organs spreading to the pericardium (secondary) rather than primary cancer of the pericardium which is very rare (mesothelioma). This may include medications, radiation, and surgery, depending on the type of cancer.
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