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Functional chest pain

Rajeev Bhardwaj
PURPOSE OF STUDY: Left bundle branch (LBBB) is common ECG finding. Common causes of LBBB are coronary artery disease (CAD), hypertension and dilated cardiomyopathy (DCM). Purpose of the study was to find out the etiology and left ventricular function in patients coming to a territory care hospital. MATERIAL AND METHODS: All consecutive patients coming to our hospital as indoor or outdoor patients with ECG suggestive of LBBB were studied. The detail history and examination was done...
September 2016: Journal of the Association of Physicians of India
Mi-Seung Shin, Seong-Mi Park, Mi-Na Kim, Hack-Lyoung Kim, Kyung-Soon Hong, Myung-A Kim, Gil-Ja Shin, Wan-Joo Shim
OBJECTIVE: Left ventricular hypertrophy (LVH) and coronary atherosclerosis are common cardiac complications of hypertension. Previous studies have shown that LVH is associated with increased cardiovascular mortality, regardless of coronary artery disease. The purpose of this study was to evaluate the relationship between LVH and significant coronary arterial stenosis in hypertensive women with chest pain. DESIGN AND METHOD: One hundred ninety four hypertensive women with eligible data from the Korean women's chest pain registry (KoROSE) study were included...
September 2016: Journal of Hypertension
Donald Nuss, Robert J Obermeyer, Robert E Kelly
Repair of pectus excavatum began at the beginning of the 20(th) century before endotracheal intubation was standard practice. Surgeons therefore developed techniques that corrected the deformity using an open procedure via the anterior chest wall. Initial techniques were unsatisfactory, but by the 1930s the partial rib resection and sternal osteotomy technique had been developed and was used in combination with external traction post-operatively to prevent the sternum from sinking back into the chest. In 1949, Ravitch recommended complete resection of the costal cartilages and complete mobilization of the sternum without external traction, and in 1961 Adkins and Blades introduced the concept of a substernal strut for sternal support...
September 2016: Annals of Cardiothoracic Surgery
Muhammad Shahid, Edward Hoey, Sandeep Basavarajaiah
We report a case of focal myocarditis in a young boy mimicking acute ST-segment elevation MI. He presented with chest pain and the EKG changes were consistent with infero-laeral ST-segment elevation MI. Coronary angiogram revealed smooth arteries with no obstruction. Troponin was significantly elevated and the echocardiogram exhibited mildly impaired LV function with hypokinetic inferior and lateral walls. Subsequently performed cardiac magnetic resonance imaging confirmed the diagnosis of myocarditis by exhibiting classic features of delayed gadolinium enhancement in the epi and mid-myocardial regions of the lateral wall sparing the sub-endocardial region...
August 24, 2016: American Journal of Cardiology
Rajashree Madabushi, Anil Agarwal, Saipriya Tewari, Sujeet K S Gautam, Sandeep Khuba
Wolff Parkinson White (WPW) syndrome is a condition in which there is an aberrant conduction pathway between the atria and ventricles, resulting in tachycardia. A 42-year-old patient, who was treated for WPW syndrome previously, presented with chronic somatic pain. With her cardiac condition in mind, she was thoroughly worked up for a recurrence of disease. As part of routine screening of all patients at our pain clinic, she was found to have severe depression as per the Patient Health Questionnaire-9 (PHQ-9) criteria...
October 2016: Korean Journal of Pain
Jacob Zeitani, Marco Russo, Eugenio Pompeo, Gian Luigi Sergiacomi, Luigi Chiariello
BACKGROUND: The aim of the study was to test the hypothesis that in patients with chronic complex sternum dehiscence, the use of muscle flap repair minimizes the occurrence of paradoxical motion of the chest wall (CWPM) when compared to sternal rewiring, eventually leading to better respiratory function and clinical outcomes during follow-up. METHODS: In a propensity score matching analysis, out of 94 patients who underwent sternal reconstruction, 20 patients were selected: 10 patients underwent sternal reconstruction with bilateral pectoralis muscle flaps (group 1) and 10 underwent sternal rewiring (group 2)...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
Martina Scharitzer, Peter Pokieser, Michaela Wagner-Menghin, Ferdinand Otto, Olle Ekberg
PURPOSE: Clinical assessment of swallowing disorders (dysphagia) requires accurate and comprehensive medical history-taking to further tailor the diagnostic work-up, but functional health care questionnaires show a large variability and various limitations. The aim of this study was to assess the way in which international swallowing experts from various disciplines asses swallowing problems in order to improve the radiologist´s ability to take a thorough medical history in this specific patient group...
October 11, 2016: Abdominal Radiology
Pelbreton C Balfour, Jorge A Gonzalez, Christopher M Kramer
Coronary artery disease (CAD) remains a significant global public health burden despite advancements in prevention and therapeutic strategies. Common non-invasive imaging modalities, anatomic and functional, are available for the assessment of patients with stable chest pain. Exercise electrocardiography is a long-standing method for evaluation for CAD and remains the initial test for the majority of patients who can exercise adequately with a baseline interpretable electrocardiogram. The addition of cardiac imaging to exercise testing provides incremental benefit for accurate diagnosis for CAD and is particularly useful in patients who are unable to exercise adequately and/or have uninterpretable electrocardiograms...
September 12, 2016: Trends in Cardiovascular Medicine
Mustafa Topuz, Ali Dogan
BACKGROUND: The aim of this study is to evaluate the effect of epicardial adipose tissue (EAT) thickness on left ventricular diastolic functions in patients with normal coronary arteries (NCA) proven by angiography. METHODS: We selected study patients who were referred to coronary angiography due to typical chest pain or atypical chest pain with a positive pre-test result for coronary artery disease. After coronary angiography, 85 patients had significant coronary lesion (≥50% stenosis) served as coronary artery disease (CAD) group, 82 patients had non-significant coronary lesion (<50% stenosis) and/or a coronary plaque served as non-significant CAD group and 83 patients had normal coronary arteries served as normal coronary artery (NCA) group...
October 7, 2016: Kardiologia Polska
Akihiko Kitahara, Seijiro Sato, Terumoto Koike, Masanori Tsuchida
We report here a case of fatal respiratory failure developed during chemotherapy for diffuse large B cell lymphoma that occurred late after lung transplantation. 25-year- old man underwent lung transplantation from brain death donor for respiratory failure due to interstitial pneumonia at the age of 16 years old. Two years after transplantation, his respiratory function decreased gradually. Chronic lung allograft dysfunction including bronchiolitis obliterans( BOS) and restrictive allograft syndrome was suspected and immunosuppression was enhanced...
October 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Jose M Remes-Troche
Chest pain that is not explained by reflux disease or cardiac, musculoskeletal, mucosal, or motor esophageal abnormalities is classified as functional chest pain (FCP). Although several mechanisms are involved, esophageal hypersensitivity plays a major role and it could be considered a biomarker for FCP. Psychologic comorbidity such as anxiety, neuroticism, depression, and somatization is common. When the diagnosis of FCP is suspected, patients should undergo evaluation with esophageal motility testing, endoscopy, 24-h esophageal pH monitoring, and in some cases, sensory tests...
October 5, 2016: Current Treatment Options in Gastroenterology
Ingrid Ølfarnes Røysland, Febe Friberg, Berit Støre Brinchmann, Sunniva Nordeide Svello, Torstein Valborgland, Alf Inge Larsen
AIMS AND OBJECTIVES: To explain the transitional process that individuals with unexplained chest pain undergo while participating in an exercise training programme over time. BACKGROUND: Angina-like chest pain in patients with no obstructive coronary artery disease is a growing problem. Functional limitations, restricted daily activities and reduced quality of life are reported. In addition, physical activity is avoided in this population. DESIGN: The study follows a qualitative classic grounded theory (Glaser 1967)...
October 5, 2016: Journal of Clinical Nursing
Mihnea Zdrenghea, Adela Sitar-Tăut, Gabriel Cismaru, Dumitru Zdrenghea, Dana Pop
Increased uric acid levels are correlated with cardiovascular disease, particularly with ischaemic heart disease. Xanthine oxidase inhibitors, especially allopurinol, lower the risk of ischaemic heart disease due to their effects on reactive oxygen species and endothelial function. In chronic stable angina pectoris, allopurinol increases the median time to ST depression, time to chest pain, and total exercise time. On the other hand, it has been reported that allopurinol has a beneficial effect on ischaemic patients referred for angioplasty, but there are insufficient data regarding its effect on acute myocardial infarction patients...
September 9, 2016: Cardiovascular Journal of Africa
Rachael Chang, Nick Murray
Anthracycline extravasation is a feared complication of intravenous (i.v.) chemotherapy due to the tissue toxicity of this group of drugs. We describe a 54-year-old woman with history of stage IIIa breast cancer, receiving adjuvant chemotherapy consisting of doxorubicin and cyclophosphamide. The chemotherapy was administered through a Poweport(®) device, the position of which was confirmed with fluoroscopy and function confirmed by flushing the line. Urgent intervention was required as patient was symptomatic and experienced severe right-sided pleuritic chest pain...
October 2016: Oxford Medical Case Reports
Michael C Turner
A 61-year-old woman presented to the emergency room with atypical chest pain, non-diagnostic electrocardiogram, and an initial troponin level that was normal. A coronary computed tomography angio (CCTA) was performed, and on initial review, it appeared to be normal. Subsequent review including evaluation of functional data from the retrospective scan identified a distal left anterior descending occlusion and an apical wall-motion abnormality with no other evidence of heart disease. This case illustrates the complementary contribution of anatomic and functional data and serves to remind us that on rare occasions, what looks "normal" is not always normal...
September 30, 2016: Echocardiography
Robert C Hsu, Joshua Burak, Sumit Tiwari, Chayan Chakraborti, Gary E Sander
BACKGROUND: Chagas disease (CD), caused by Trypanosoma cruzi, affects 6-7 million people worldwide annually, primarily in Central and South America, and >300,000 people in the United States. CD consists of acute and chronic stages. Hallmarks of acute CD include fever, myalgia, diaphoresis, hepatosplenomegaly, and myocarditis. Symptoms of chronic CD include pathologic involvement of the heart, esophagus, and colon. Myocardial involvement is identifiable by electrocardiogram and cardiac magnetic resonance imaging showing inflammation and left ventricular wall functional abnormalities...
2016: Ochsner Journal
Yan Wen, Chao Zhang, Xiao-Feng Zhao, Shi-Zhe Deng, Si He, Ling-Hui Huang, Guang Tian, Zhi-Hong Meng
Acupuncture at Fengchi (GB20) in the posterior neck improves vertigo. However, subarachnoid hemorrhage and spinal epidural hematoma have been reported to occur after acupuncture in the posterior neck. Therefore, in the present study, we assessed the safety of acupuncture at Fengchi. Laboratory tests and adverse event reports were used to evaluate the safety of different acupuncture manipulations for the treatment of posterior circulation ischemia with vertigo. A total of 136 patients were randomly assigned to four groups...
August 2016: Neural Regeneration Research
Maseeh Uz Zaman, Nosheen Fatima, Areeba Zaman, Unaiza Zaman, Rabia Tahseen
For vasodilator stress, myocardial perfusion imaging (MPI) with at least 12-h caffeine abstinence is recommended, as it attenuates cardiovascular hyperemic response of adenosine and dipyridamole. However, many published conflicting results have shown no significant effect upon perfusion abnormalities in MPI performed without caffeine abstinence. The aim of this study was to compare the hemodynamic changes and negative predictive value (NPV) of normal MPIs with adenosine stress performed with or without caffeine abstinence...
September 2016: World Journal of Nuclear Medicine
Mi-Seung Shin, Seong-Mi Park, Mi-Na Kim, Hack-Lyoung Kim, Kyung-Soon Hong, Myung-A Kim, Gil-Ja Shin, Wan-Joo Shim
OBJECTIVE: Left ventricular hypertrophy (LVH) and coronary atherosclerosis are common cardiac complications of hypertension. Previous studies have shown that LVH is associated with increased cardiovascular mortality, regardless of coronary artery disease. The purpose of this study was to evaluate the relationship between LVH and significant coronary arterial stenosis in hypertensive women with chest pain. DESIGN AND METHOD: One hundred ninety four hypertensive women with eligible data from the Korean women's chest pain registry (KoROSE) study were included...
September 2016: Journal of Hypertension
Mazen El Sayed, Hani Tamim, Ahel Al-Hajj Chehadeh, Amin A Kazzi
BACKGROUND: Early activation and use of Emergency Medical Services (EMS) are associated with improved patient outcomes in EMS priority conditions in developed EMS systems. This study describes patterns of EMS use and identifies predictors of EMS utilization in EMS priority conditions in Lebanon METHODS: This was a cross-sectional study of a random sample of adult patients presenting to the emergency department (ED) of a tertiary care center in Beirut with the following EMS priority conditions: chest pain, major trauma, respiratory distress, cardiac arrest, respiratory arrest, and airway obstruction...
September 19, 2016: Prehospital and Disaster Medicine
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