The Man With Chest Pain—and Dry Eyes

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Mr. Patel, 64, came in with angina. His ECG and troponin levels were borderline. What struck me most was his persistently dry eyes, which he mentioned casually.

Further testing revealed positive anti-Ro/SSA antibodies and he was diagnosed with Sjögren’s syndrome—a systemic autoimmune disease. A coronary CT angiogram showed small-vessel coronary disease, likely autoimmune in origin.


He received immunosuppressive therapy and nitrates, with significant improvement.


The Lesson Learned

Systemic diseases often bridge specialties. Dry eyes and chest pain in the same patient may point to something larger. Collaborate. The patient is one person, not divided by specialty.

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