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manuelletherapie 2019; 23(04): 184-189
DOI: 10.1055/a-0978-3891
Fallbericht
© Georg Thieme Verlag KG Stuttgart · New York

Koronare Herzkrankheit als Ursache für Beschwerden im Bereich von BWS und Sternum

FallberichtCoronary Myocardial Disease as Cause of Complaints in the Area of the Thoracic Spine and SternumCase Report
Wolfgang Lackenbauer
1   Manchester Metropolitan University, Dept. of Health Professions, Manchester, Great Britain
2   IMC, FH Krems, Krems, Österreich
› Author Affiliations
Further Information

Publication History

03 September 2018

08 October 2018

Publication Date:
13 September 2019 (online)

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Zusammenfassung

Eine 80-jährige Patientin mit chronischen Schmerzen in der LWS, zusätzlichem Druck-/Engegefühl im Brustkorb bzw. hinter dem Brustbein sowie Atemlosigkeit vor allem bei physischer Anstrengung mit gleichzeitig auftretenden Schmerzen in der BWS zwischen den Schulterblättern wurde zur Physiotherapie überwiesen. Die Symptome im Bereich Brustkorb/Sternum und der BWS ließen sich weder durch eine Haltungsänderung noch durch Aktivität/Bewegung der oberen Extremitäten oder der Wirbelsäule auslösen bzw. reproduzieren.

Aufgrund des für koronare Herzkrankheiten typischen Beschwerdebildes wurde die Patientin zur weiteren fachärztlichen Abklärung überwiesen. Kurz darauf unterzog sie sich einer 4-fachen Bypass-Operation am Herzen.

Abstract

An 80-year old female patient with chronic low back pain, additional feelings of pressure/tightness in the chest region and behind the breast bone as well as breathlessness and concomitant pain in the thoracic spine between the scapulae was referred to physiotherapy. The symptoms in the area of chest/sternum and the thoracic spine could not be provoked by postural change or by upper limb and spinal column activity/movement.

Due to the typical clinical presentation of coronary myocardial disease, the patient was sent for further specialist assessment. A few days later she underwent a quadruple bypass heart surgery.

Schlüsselwörter

Differenzialdiagnose - Red Flags - Physiotherapie - koronare Herzkrankheit - klinischer Entscheidungsprozess

Key words

differential diagnosis - red flags - physiotherapy - coronary myocardial disease - clinical decision-making process
 

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