An adult with a 20 pack-year history of smoking and essential hypertension presented to the emergency department with complaints of intermittent, sharp, nonradiating epigastric and substernal pain of one month's duration. Other symptoms included increasing dysphagia, decreased appetite, and 10 lb weight loss over one month. There was no alleviation with antacids. The patient denied fever, night sweats, and shortness of breath. Initial laboratory evaluation showed leukocytosis at approximately 14,000; hyponatremia at 133; and hypochloremia at 96. An electrocardiogram demonstrated sinus tachycardia with possible left atrial enlargement and left ventricular hypertrophy. Troponins were negative.
Appl Radiol. 2023;52(1):46-48. © 2023 Anderson Publishing, Ltd.