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Chest pain: a diagnostic challenge
  1. Ashish Chawla,
  2. Dinesh Singh
  1. Department of Diagnostic Radiology, Khoo Teck Puat Hospital, Singapore, Singapore
  1. Correspondence to Dr Ashish Chawla, Department of Diagnostic Radiology, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore 768828, Singapore; ashchawla{at}

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Clinical introduction

A 47-year-old man presented to the emergency department with non-radiating central chest pain, since the last 2 days. The pain was associated with vomiting, and there was no preceding history of trauma. The patient had experienced multiple similar episodes of chest pain in the last 5 years, which had resolved with home remedy. He had significant weight loss in the last few months, which was attributed to poor food intake and frequent vomiting. Physical examination revealed bibasilar crepitations, and the ECG was unremarkable. A frontal chest radiograph was obtained (figure 1).

Figure 1

Frontal chest radiograph.


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