Anomalous course of the carotid arteries in the retrooesophageal space An unusual cause of chest pain英文文献资料.docVIP

World Journal of Cardiovascular Diseases, 2012, 2, 326-329 WJCD /10.4236/wjcd.2012.24052 Published Online October 2012 (http://www.SciRP.org/journal/wjcd/) Anomalous course of the carotid arteries in the retrooesophageal space: An unusual cause of chest pain Giorgio Bosso, Antonio Valvano, Valentina Apuzzi, Filippo Riccone, Ugo Oliviero * Department of Internal Medicine and Cardiovascular Sciences, University of Naples Federico II, Naples, Italy * Email: ugo.oliviero@unina.it Received 21 August 2012; revised 20 September 2012; accepted 28 September 2012 ABSTRACT of the patients referring to the emergency department [1]. It is a frequent manifestation in both cardiac and non- cardiac diseases, and the differential diagnosis represents one of the most difficult challenges for clinicians, in- cluding many conditions affecting thoracic and abdomi- nal organs [2]. Failure to recognize potentially serious conditions such as acute coronary syndrome, aortic dis- section, pneumothorax, or pulmonary embolism can rise to severe complications [3], otherwise, the inappropriate research of noncardiac causes of chest pain can deter- mine needless hospital admissions, expansive tests, painful procedures, and anxiety [4]. The diagnosis of noncardiac chest pain is provided by the recurrence of chest pain episodes indistinguishable from corononary events after that a reasonable flow-chart allows to ex- clude a cardiac cause [5], until to the performance of coronary angiography, which shows a normal or an in- significant degree of obstruction in up to 30% of the cases [6]. Noncardiac chest pain may be of muscu- loskeletal, pulmonary, gastroenterological, psychoso- matic or neurological aetiology. Oesophageal disorders are the most common cause of atypical chest pain [7]; the main underlying mechanisms include gastroesopha- geal reflux [8], oesophageal dysmotility