04.09.2012: The story of painful noisy pneumothorax that was overlooked could have happened to any of us. The description of the patient, the search for a diagnosis and the subsequent discussion are exemplary, self-critical and absolutely something to learn from. The story gives rise to many reflections – for example, over the diagnosis of pneumothorax and when it is safe to fly with or after a pneumothorax. Nagasheth and Kurek found that chest X-rays had a sensitivity for revealing pneumothorax of only 32 % of that achieved with CT, while ultrasound scanning was far better, at 82 % (1). If the air cap is...

04.09.2012: Pulmonary hypertension is a complex, multidisciplinary disease for which the classification and guidelines for diagnostics and treatment were revised in 2009 (1, 2). The mean pressure in arteria pulmonalis is by definition ≥ 25 mm Hg at rest, determined by means of right-sided heart catheterisation. In the precapillary type of pulmonary hypertension (Groups 1, 3, 4, and 5) pulmonary artery wedge pressure is ≤ 15 mm Hg and reflects normal pressure in the left atrium. This is in contrast to post-capillary pulmonary hypertension with > 15 mm Hg (Group 2), reflecting increased filling pressure in...

04.09.2012: Dyspnoea is not uncommon in patients with a cancer diagnosis, and can represent several differential diagnostic possibilities. We describe a case of persistent and increasing dyspnoea in a woman in her 40s who previously had been treated for breast cancer with metastasis to lymph nodes. A woman in her 40s was admitted to the Medical Department after a two-month history of chest pain radiating to both axillae. On the day prior to admission, the patient experienced escalating exacerbation of chest pain, particularly in connection with inspiration and lying on her side in bed. For the first 2 – 3...

04.09.2012: Chest pain is a common cause of hospitalisation. Sometimes a conspicuous examination finding can lead to the wrong conclusions and cause important findings of major clinical importance to be overlooked. A man in his early 20s was admitted to the medical department of the local hospital because of almost two days of chest pain. The pain started in the centre of his chest and gradually moved over to the left. It was exacerbated by deep inhalation and lying on his left side. The patient had no other symptoms. Two weeks prior to admission he had had similar chest pain that had ceased spontaneously...