Chest Pain and Palpitations After Spinal Surgery: An Atypical Presentation of Acute Cholecystitis.

Acute cholecystitis is a common disease that affects ~200,000 people in the United States each year. Early diagnosis and gallbladder removal are associated with improved patient outcomes, including fewer postoperative complications, shorter length of stay, and lower hospital costs. Acute cholecystitis typically presents with right upper quadrant (RUQ) pain associated with nausea and vomiting. The pathophysiological mechanism of RUQ pain corresponds with dermatomes that arise from thoracic spinal cord levels T6 to T8. We describe a case of a 40-year-old male who presented with a 2-day history of substernal chest pain, which was worked up for acute coronary syndrome and was later found to have acute cholecystitis. This atypical presentation was attributed to the patient's history of a paraspinal schwannoma after resection with laminectomy, complicated by persistent right hemi-thoracoabdominal paresthesia. We aim to shed light on this atypical presentation of acute cholecystitis.