Contraceptive ID'd as Culprit in Patient with Shortness of Breath, Chest Pain
A case presented at the American Thoracic Society 2017 meeting in Washington, D.C. describes a young patient whose shortness of breath and chest pain were the result of a displaced intrauterine device (IUD).
The patient, a 24-year-old female, presented to the emergency department with shortness of breath and severe chest pain; the pain was on her left side and radiated to her left shoulder. A chest X-ray was ordered, and it was revealed that her IUD was within her abdominal cavity. After a general surgery and gynecology consult, the patient was taken into surgery to have the IUD removed. "Atraumatic grasper was used to grasp the IUD and to remove it through the umbilical port site without any complications," the authors noted. The patient's shoulder pain resolved after the surgery and she was discharged the next day.
While IUD displacement has been discussed in the literature, the authors could not find a similar case which showed a displaced IUD reaching the diaphragm and causing chest pain. Confirmation of correct positioning is important and should be done at regular intervals as most women are unaware of displacement until it causes internal injury.
"This case highlights the fact that while evaluating young females we should ask about method of contraception and keep misplaced IUD in mind for differential diagnosis," the authors concluded.
Reference: Rehman, S., M.D., Kahn, N.S., M.B.B.S, Vacek, T., M.D., Ali, A, M.D., Assaly, R., M.D., Hammersley, J.R., M.D., "Chest Pain and Shortness of Breath in a Young Lady, Don't Forget to Ask About Contraception"