Nor could she explain his newest symptom, a strange and thunderous pounding She wasn’t sure what had caused that week of chest pain either. The patient went to see his new primary care doctor a few days later. When the patient was sent home the following day, his chest still a little sore, neither he nor any of his doctors had any idea what had caused the problem. The sharp pain he had felt deep inside made his doctors worry that his aorta, the vessel that carries blood from the heart to the rest of the body, had been torn, but a CT scan of his chest An echocardiogram, an ultrasound of the heart in motion, showed that the organ was And the blood tests designed to look for evidence of even minor damage to the heart muscle were negative. But his age and gender made it an important possibility.īut his EKG was normal. He had none of the usual risk factors for heart disease – he didn’t smoke andĭidn’t have high blood pressure or diabetes. In the emergency department, the staff assumed the 59-year-old man complaining of chest pain was having a heart attack. When the soreness was still there nearly a week later, the man allowed his worried partner to take him to the Hackettstown Regional Medical Center in New Jersey. There was a kind of soreness, as if some muscle deep inside had been worked way too hard. The next morning the pain was still there. He wasn’t certain how long the intense pain lasted, but eventually the weight began to lighten and She’d lost her father to a heart attack when he was younger than this man she loved. His girlfriend stared at his pale, distressed face.

Ripples of pain radiated upward from his chest into his And deep inside, something sharp as a knife jabbed at the place he figured his heart must be. It was a pain unlike anything he’d ever felt before. “Something’s not right,” the middle-aged man said suddenly, leaning forward on the sofa. To make a diagnosis you think accounts for this troublesome symptom.Īs usual, the first person to crack the case gets a copy of my book, “Every Patient Tells a Story,” and that warm feeling you get when you solve a mystery.

After that, it’s up to you to use the information I’ll give you the key bits of information available to the doctors who saw him, including the medical images. Patient, in general, appeared to be so healthy. This month’s puzzle is particularly tough because the The Challenge: Can you solve a real-life medical mystery involving a 59-year-old man tormented by a thunderous pounding in his head?Įvery month the Diagnosis column of The New York Times Magazine asks Well readers to sift through a difficult medical case and solve a diagnostic riddle.

Lisa sanders new york times