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The Use of Osteopathic Manipulative Medicine During the Inpatient Evaluation for Acute Coronary Syndrome

Journal: The AAO Journal Date: 2025/06, 35(2):Pages: 6-7. doi: Subito , type of study: case report

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/35/2/article-p5.xml)

Keywords:

case report [723]
chest pain [20]
costochondritis [1]
diagnosis [399]
male [826]
OMT [3776]
osteopathic manipulative treatment [3796]

Abstract:

Introduction: While musculoskeletal causes for chest pain are common, in the acute setting, standard of care is to rule out life-threatening conditions and does not include the use of osteopathic evaluation and treatment. This case provides an example of how diagnostic and therapeutic osteopathic medicine is of value when implemented concurrently with standard of care during evaluation for acute coronary syndrome (ACS). Case: A 54-year-old male presented with typical cardiac chest pain and was admitted for an ischemic evaluation by cardiology. Upon admission, osteopathic manipulative medicine (OMM) performed by the hospitalist service was used in parallel with the standard of care to evaluate and treat chest pain, which was highly suspicious for ACS. Daily osteopathic treatments using myofascial release and balanced ligamentous tension were targeted at the patient's specific somatic dysfunction discovered via osteopathic structural examination (OSE). Results: OSE was diagnostic for costochondritis and somatic dysfunction prior to definitive ACS rule out via coronary angiography. Osteopathic Manipulative Treatment (OMT) resulted in an immediate post-treatment pain reduction of 5 points on a 10 point pain scale. Subsequent treatments resulted in an average of 3.67 point reduction over the hospital course (3 days), with a downward trend in baseline pain. OMM allowed for a diagnosis of costochondritis and provided the patient a clear etiology for his chest pain. Discussion: This case outlines how OMM is complementary to the standard of care in the acute setting and is a valuable part of an interdisciplinary approach, providing benefits such as expedited patient recovery and reduced length of stay. Further research should be conducted to guide the use of inpatient OMM for evaluation and treatment of acute chest pain regardless of the initial differential.


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