Small Calcification, Severe Chest Pain: Pectoralis Major Calcific Tendinopathy Masquerading as Cardiac Emergency

Background: Chest pain is a frequent cause of emergency department consultations, often requiring exclusion of life threatening conditions. We present a rare case of calcific tendinopathy of the pectoralis major tendon mimicking a cardiac emergency. Case Presentation: A 70 year old man presented with severe atraumatic left sided chest pain radiating to the shoulder and arm. Initial clinical and laboratory findings excluded cardiac and vascular causes. Computed tomography and ultrasound revealed pronounced calcification at the humeral insertion of the pectoralis major tendon. Conservative therapy was insufficient, while ultrasound guided percutaneous lavage with triamcinolone infiltration led to marked symptom resolution. Conclusion: Calcific tendinopathy of the pectoralis major represents an extraordinarily rare cause of acute chest pain. Recognition of this condition is essential to avoid unnecessary cardiac work up and to provide targeted therapy.