A Rare Cause Of Chest Pain In A Healthy Football Coach - Page #1

Author: Brian Grundt, DO
Co Author #1: Amanda Phillips, MD, MPH
Senior Editor: Justin Mark Young, MD
Editor: Peter Seidenberg, MD

Patient Presentation:
This is a 43 year-old male with no significant past medical history who presented with complaints of chest pain as well as a painful linear mass on the left anterior chest.

He had been experiencing pain in this region for approximately two weeks and first noticed the firm linear lesion approximately one week after onset of pain. He denied fevers, shortness of breath, palpitations, abnormal bleeding, rashes, or having pain or lesions in any other locations on his body. He reported holding pads while working with the linebackers during hand placement and tackling drills during football practice but denied any significant trauma compared to normal. He became concerned and chose to seek medical attention for this pain after his brother passed away suddenly from hypertrophic cardiomyopathy.

Physical Exam:
Height: 68", Weight: 210 lbs, BP: 130/80, Heart rate: 49 BPM, respiratory rate: 16, O2 saturation: 99% on room air

General: awake, alert, no apparent distress
Head: atraumatic, normocephalic
Cardiac: bradycardic, normal rhythm, no murmur
Pulmonary: non-labored breathing, lung fields clear, no wheezing.
Abdominal: soft, nontender, normoactive bowel sounds
Skin: palpable and tender area of induration an approximately 3 mm wide extending from the left anterior chest inferiorly for approximately 15 cm
Lymph: no lymphadenopathy

Case Photo #1 Case Photo #2

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