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Functional chest pain

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https://www.readbyqxmd.com/read/29350536/diagnostic-accuracy-of-functional-imaging-and-biochemical-tests-for-patients-presenting-with-chest-pain-to-the-emergency-department-a-systematic-review-and-meta-analysis
#1
Mario Iannaccone, Sebastiano Gili, Ovidio De Filippo, Salvatore D'Amico, Marco Gagliardi, Maurizio Bertaina, Silvia Mazzilli, Sara Rettegno, Federica Bongiovanni, Paolo Gatti, Fabrizio Ugo, Giacomo G Boccuzzi, Salvatore Colangelo, Silvia Prato, Claudio Moretti, Maurizio D'Amico, Patrizia Noussan, Roberto Garbo, David Hildick-Smith, Fiorenzo Gaita, Fabrizio D'Ascenzo
BACKGROUND: Non-invasive ischaemia tests and biomarkers are widely adopted to rule out acute coronary syndrome in the emergency department. Their diagnostic accuracy has yet to be precisely defined. METHODS: Medline, Cochrane Library CENTRAL, EMBASE and Biomed Central were systematically screened (start date 1 September 2016, end date 1 December 2016). Prospective studies (observational or randomised controlled trial) comparing functional/imaging or biochemical tests for patients presenting with chest pain to the emergency department were included...
January 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29345690/clozapine-induced-myocarditis
#2
COMMENT
Tanuka Datta, Allen J Solomon
Approved in 1989 for the management of treatment-resistant schizophrenia, Clozapine is a last-line atypical antipsychotic drug used with increasing frequency. In addition to its well-known side effect of agranulocytosis, this drug also carries with it rare but serious adverse cardiovascular risk of myocarditis. We present a patient on Clozapine who was admitted to the cardiology service with chest pain, ST segment elevations and elevated troponin concerning for acute myocardial infarction. Evaluation with imaging revealed decreased left ventricular function, however, no coronary artery disease was present on catheterization; findings consistent with a diagnosis of myocarditis...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29334505/the-association-of-chronic-air-pollutants-with-coronary-artery-spasm-vasospastic-angina-and-endothelial-dysfunction
#3
Byoung Geol Choi, Jiwon Lee, Suhng Wook Kim, Min Woo Lee, Man Jong Baek, Yang Gi Ryu, Se Yeon Choi, Jae Kyeong Byun, Ahmed Mashaly, Yoonjee Park, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Seung-Woon Rha
BACKGROUND: We evaluated the effect of chronic exposure to air pollutants (APs) on coronary endothelial function and significant coronary artery spasm (CAS) as assessed by intracoronary acetylcholine (ACH) provocation test. PATIENTS AND METHODS: A total of 6430 patients with typical or atypical chest pain who underwent intracoronary ACH provocation test were enrolled. We obtained data on APs from the Korean National Institute of Environmental Research (http://www...
January 12, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29325338/-supplementation-with-high-dose-l-carnitine-on-hemodialysis-tolerance-in-uremic-patients-with-severe-heart-diseases
#4
Y J Pan, F P Lu
Objective: To investigate the effect of intravenous supplementation with high-dose L-carnitinen on hemodialysis tolerance in uremic patients with severe heart disease (ischemic heart disease, congestive heart disease and arrhythmia). Methods: Between March 2012 and March 2017, 5 gram L-carnitine was given after the completion of each hemodialysis treatment (3-4 times a week) over a period of two weeks in 29 maintenance hemodialysis patients with severe heart diseases manifested by frequently symptomatic hypotension, chest tightness, wheezing, palpitation, chest pain and other symptoms during hemodialysis...
December 26, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29316368/rash-fever-and-pulmonary-hypertension-in-a-6-year-old-female
#5
David Buchbinder, Gina A Montealegre Sanchez, Raphaela Goldbach-Mansky, Hermine Brunner, Andrew I Shulman
A previously healthy 2-year-old Guatemalan female with an undiagnosed chronic illness characterized by fever and rash had presented with anorexia, weight loss, periorbital edema, abdominal pain and distention. A chest radiograph documented cardiomegaly. An echocardiogram demonstrated a pericardial effusion, dilated right atrium, right ventricle, and main pulmonary artery as well as diminished right ventricular systolic function and pulmonary hypertension. Right ventricular systolic pressure was estimated at 90 mmHg...
January 5, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29316246/sleep-quality-and-functional-gastrointestinal-disorders-a-psychological-issue
#6
Michel Bouchoucha, Florence Mary, Cyriaque Bon, Bakhtiar Bejou, Gheorghe Airinei, Robert Benamouzig
BACKGROUND / AIMS: Sleep disorders are often associated with functional gastro-intestinal disorders (FGIDs). This study aims to evaluate the association of sleep disorders with specific FGIDs and to assess the related importance of psychological disorders. METHODS: We included 1009 consecutive FGID patients (71% female), aged 48.2 ± 16.7 years (M±SD), BMI 26.9 ± 11.2 kg/m2 . These patients filled in a Rome III questionnaire and underwent a psychological evaluation on anxiety and depression...
January 8, 2018: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/29314737/airway-inflammation-in-sickle-cell-disease-a-translational-perspective
#7
REVIEW
Aliva De, Deepa Manwani, Deepa Rastogi
Asthma and sickle cell disease (SCD) are common chronic conditions in children of African ancestry that are characterized by cough, wheeze, and obstructive patterns on pulmonary function. Pulmonary function testing in children with SCD has estimated a prevalence of obstructive lung disease ranging from 13% to 57%, and airway hyper-responsiveness of up to 77%, independent of a diagnosis of asthma. Asthma co-existing with SCD is associated with increased risk of acute chest syndrome (ACS), respiratory symptoms, pain episodes, and death...
January 4, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29302537/morbidity-pattern-and-its-relation-to-functional-limitations-among-old-age-rural-population-in-kerala-india
#8
R Anil Das, S Ganesh Kumar, Gautam Roy
Background: In the present era of demographic transition, morbidity pattern among geriatric population and its relation to functional limitations is an important health issue in developing countries. Objective: The objective of this study was to assess the reported morbidities and its relation to functional limitations among rural geriatric population. Materials and Methods: A community-based cross-sectional study was carried out among 167 old age participants aged ≥60 years to assess morbidities and its relation to functional limitations in a rural area of Kerala, India...
April 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29288156/left-ventricular-torsion-shear-angle-volume-approach-for-noninvasive-evaluation-of-diastolic-dysfunction-in-preserved-ejection-fraction
#9
Oleg F Sharifov, Chun G Schiros, Inmaculada Aban, Gilbert J Perry, Louis J Dell'italia, Steven G Lloyd, Thomas S Denney, Himanshu Gupta
BACKGROUND: Accurate noninvasive diagnostic tools for evaluating left ventricular (LV) diastolic dysfunction (LVDD) are limited in preserved LV ejection fraction. We previously proposed the relationship of normalized rate of change in LV torsion shear angle (φ') to corresponding rate of change in LV volume (V') during early diastole (represented as -dφ'/dV') as a measure of LV diastolic function. We prospectively evaluated diagnostic accuracy of -dφ'/dV' in respect to invasive LV parameters...
December 29, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29242100/takotsubo-is-not-a-cardiomyopathy
#10
Francesco Pelliccia, Gianfranco Sinagra, Perry Elliott, Guido Parodi, Cristina Basso, Paolo G Camici
Unraveling the mechanisms underlying Takotsubo (TTS) leads to question the current inclusion of the condition within the spectrum of cardiomyopathies. Indeed, the clinical presentation and pathophysiology of TTS clearly differ from cardiomyopathies, i.e. diseases of heart muscle unexplained by abnormal loading conditions or coronary artery disease, which cannot recover spontaneously and may cause sudden death often in minimally symptomatic individuals or result in a gradual deterioration in ventricular function and end-stage heart failure...
December 9, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29242010/heart-rate-variability-analysis-in-patients-who-have-bradycardia-presenting-to-the-emergency-department-with-chest-pain
#11
Jeffrey Tadashi Sakamoto, Nan Liu, Zhi Xiong Koh, Dagang Guo, Micah Liam Arthur Heldeweg, Janson Cheng Ji Ng, Marcus Eng Hock Ong
BACKGROUND: Heart rate variability (HRV) is a noninvasive method to measure the function of the autonomic nervous system. It has been used to risk stratify patients with undifferentiated chest pain in the emergency department (ED). However, bradycardia can have a modifying effect on HRV. OBJECTIVE: In this study, we aimed to determine how bradycardia affected HRV analysis in patients who presented with chest pain to the ED. METHODS: Adult patients presenting to the ED at Singapore General Hospital with chest pain were included in the study...
December 11, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29240719/pericardial-effusion-as-a-presenting-symptom-of-hashimoto-thyroiditis-a-case-report
#12
Alberto Leonardi, Laura Penta, Marta Cofini, Lucia Lanciotti, Nicola Principi, Susanna Esposito
Background: Hashimoto thyroiditis (HT) is the most frequent cause of acquired hypothyroidism in paediatrics. HT is usually diagnosed in older children and adolescents, mainly in females and is rare in infants and toddlers with cardiac involvement, including pericardial effusion, that can be found in 10% to 30% of adult HT cases. In this paper, a child with HT and pericardial effusion as the most important sign of HT is described. Case presentation: A four-year-old male child suffering for a few months from recurrent abdominal pain sometimes associated with vomiting underwent an abdominal ultrasound scan outside the hospital...
December 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29239257/cardiac-magnetic-resonance-assessment-of-diastolic-dysfunction-in-acute-coronary-syndrome
#13
Shah M Azarisman, Karen S Teo, Matthew I Worthley, Stephen G Worthley
Chest pain is an important presenting symptom. However, few cases of chest pain are diagnosed as acute coronary syndrome (ACS) in the acute setting. This results in frequent inappropriate discharge and major delay in treatment for patients with underlying ACS. The conventional methods of assessing ACS, which include electrocardiography and serological markers of infarct, can take time to manifest. Recent studies have investigated more sensitive and specific imaging modalities that can be used. Diastolic dysfunction occurs early following coronary artery occlusion and its detection is useful in confirming the diagnosis, risk stratification, and prognosis post-ACS...
December 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29226507/age-is-the-only-predictor-of-small-decrease-in-lung-function-in-children-with-sickle-cell-anemia
#14
Shaina M Willen, Robyn Cohen, Mark Rodeghier, Fenella Kirkham, Susan S Redline, Carol Rosen, Jane Kirkby, Michael R DeBaun
The longitudinal pattern of lung function in children with sickle cell anemia (SCA) has shown a decrease in FEV1 % predicted, a risk factor for death in adults with SCA, but predictors for this decline are poorly characterized. In a prospective longitudinal multi-center cohort of children with SCA, we tested the hypotheses that: 1) FEV1 % predicted declines over time; and 2) SCA-specific characteristics and therapy predict this decline. At three clinical centers, children with SCA (HbSS or HbSβ0 thalassemia), unselected for respiratory disease, were enrolled in the Sleep and Asthma Cohort (SAC) study...
December 11, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/29223276/a-51-year-old-woman-with-an-increasing-chest-wall-mass-years-after-resection-of-an-early-stage-lung-cancer
#15
Ajay Dhakal, Hongbin Chen, Elisabeth U Dexter
A 51-year-old woman was found to have a new 14 × 6 mm soft tissue mass under the right serratus muscle on a CT scan of the chest performed for routine surveillance due to her history of stage I lung cancer. A follow-up CT scan performed 4 months later showed that the mass had increased in size to 22 × 8 mm. The patient presents to the oncology clinic to discuss the results of the CT scan. She has no pain or swelling on the right lateral chest and no cough, fever, or shortness of breath. She is at her baseline health with good appetite and functional status...
December 2017: Chest
https://www.readbyqxmd.com/read/29222132/invasive-assessment-of-the-coronary-microvasculature-the-index-of-microcirculatory-resistance
#16
REVIEW
William F Fearon, Yuhei Kobayashi
Traditionally, invasive coronary physiological assessment has focused on the epicardial coronary artery. More recently, appreciation of the importance of the coronary microvasculature in determining patient outcomes has grown. Several invasive modalities for interrogating microvascular function have been proposed. Angiographic techniques have been limited by their qualitative and subjective nature. Doppler wire-derived coronary flow reserve has been applied in research studies, but its clinical role has been limited by its lack of reproducibility, its lack of a clear normal value, and the fact that it is not specific for the microvasculature but interrogates the entire coronary circulation...
December 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29221351/extracorporeal-membrane-oxygenation-system-as-a-bridge-to-reparative-surgery-in-ventricular-septal-defect-complicating-acute-inferoposterior-myocardial-infarction
#17
Jose Rozado, Isaac Pascual, Pablo Avanzas, Daniel Hernandez-Vaquero, Ruben Alvarez, Rocio Díaz, Beatriz Díaz, María Martín, Amelia Carro, Guillermo Muñiz, Jacobo Silva, Cesar Moris
Post-infarction ventricular septal defect (VSD) is a rare but potentially lethal complication of acute myocardial infarction. Medical management is usually futile, so definitive surgery remains the treatment of choice but the risk surgery is very high and the optimal timing for surgery is still under debate. A 55-year-old man with no previous medical history attended the emergency-room for 12 h evolution of oppressive chest pain and strong anginal pain 7 days ago. On physical examination, blood pressure was 96/70 mmHg, pansystolic murmur over left sternal border without pulmonary crackles...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29203590/a-first-in-human-phase-1-study-of-subcutaneous-outpatient-recombinant-human-il-15-rhil-15-in-adults-with-advanced-solid-tumors
#18
Jeffrey S Miller, Chihiro Morishima, Douglas G McNeel, Manish R Patel, Holbrook E Kohrt, John A Thompson, Paul M Sondel, Heather A Wakelee, Mary L Disis, Judith C Kaiser, Martin A Cheever, Howard Streicher, Stephen P Creekmore, Thomas A Waldmann, Kevin C Conlon
PURPOSE: Preclinical data established Interleukin-15 as a homeostatic factor and powerful stimulator of NK and CD8+ T cell function, the basis for clinical testing. EXPERIMENTAL DESIGN: A first-in-human outpatient phase I dose escalation trial of subcutaneous (SC) rhIL-15 was conducted in refractory solid tumor cancer patients. Therapy consisted of daily (Monday - Friday) SC injections of rhIL-15 for two consecutive weeks (10 total doses/cycle). Clinical response was assessed by RECIST...
December 4, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29199161/indications-of-24-h-esophageal-ph-monitoring-capsule-ph-monitoring-combined-ph-monitoring-with-multichannel-impedance-esophageal-manometry-radiology-and-scintigraphy-in-gastroesophageal-reflux-disease
#19
Rukiye Vardar, Muharrem Keskin
Ambulatory esophageal pH monitoring is an essential method in patients exhibiting signs of non-erosive reflux disease (NERD) to make an objective diagnosis. Intra-esophageal pH monitoring is important in patients who are non-responsive to medications and in those with extraesophageal symptoms, particularly in NERD, before surgical interventions. With the help of the wireless capsule pH monitoring, measurements can be made under more physiological conditions as well as longer recordings can be performed because the investigation can be better tolerated by patients...
December 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/29194510/correlation-of-biologically-effective-dose-and-the-tumor-control-in-stage-i-5-cm-non-small-cell-lung-cancer-with-stereotactic-ablative-radiotherapy-a-single-institutional-cohort-study
#20
Wan Jeon, Sung-Ja Ahn, Young-Chul Kim, In-Jae Oh, Chul-Kyu Park, Jae-Uk Jeong, Mee Sun Yoon, Ju-Young Song, Taek-Keun Nam, Woong-Ki Chung
Backgrounds: Stereotactic ablative radiotherapy (SABR) is one of the newly developed innovative radiotherapy and of which optimal dose prescription needs to be standardized. We aimed to investigate the dose-response relationship for patients with SABR. Methods: Fifty-three patients with Stage I non-small cell lung cancer patients, who underwent SABR between November 2006 and January 2015, were evaluated retrospectively. Thirteen patients (24.5%), who refused the surgery were included and 40 patients (75...
November 29, 2017: Japanese Journal of Clinical Oncology
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