Xiphodynia Mimicking Acute Coronary Syndrome

Intern Med. 2015;54(12):1563-6. doi: 10.2169/internalmedicine.54.3449. Epub 2015 Jun 15.

Abstract

A 79-year-old man with diabetes and partial gastrectomy visited our hospital due to gradually worsening epigastric pain on exertion. Unstable angina was suspected and coronary angiography was performed, which revealed severe stenosis of the left ascending artery. Despite successful intervention, the pain persisted. A careful physical examination finally revealed the point of tenderness on the xiphoid process, and the patient was diagnosed with xiphodynia. The severe epigastric pain resolved immediately after xiphoidectomy. This case demonstrates that symptoms of xiphodynia may mimic those of various types of disorders, such as angina, and that careful palpation is warranted during routine physical examinations.

Publication types

  • Case Reports

MeSH terms

  • Acute Coronary Syndrome / diagnostic imaging*
  • Acute Coronary Syndrome / therapy
  • Aged
  • Coronary Angiography
  • Diagnosis, Differential
  • Gastrectomy
  • Humans
  • Male
  • Pain / etiology*
  • Percutaneous Coronary Intervention
  • Treatment Outcome
  • Xiphoid Bone / diagnostic imaging
  • Xiphoid Bone / injuries*
  • Xiphoid Bone / surgery*