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Functional chest pain

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https://www.readbyqxmd.com/read/28416007/disseminated-alveolar-echinococcosis-resembling-metastatic-malignancy-a-case-report
#1
Laura Caire Nail, Ezequiel Rodríguez Reimundes, Christelle Weibel Galluzzo, Dan Lebowitz, Yasmine Lucile Ibrahim, Johannes Alexander Lobrinus, François Chappuis
BACKGROUND: Alveolar echinococcosis is a potentially lethal zoonosis caused by larval forms of the tapeworm Echinococcus multilocularis. Humans are aberrant intermediate hosts who become infected by ingestion of egg-contaminated food or water or via physical contact with domestic or wild animals that carry the parasite in their small intestine. In humans, the disease usually affects the liver and can spread to other organs causing metastatic infiltration. In this report, we describe an advanced presentation of human alveolar echinococcosis mimicking metastatic malignancy...
April 18, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28400932/role-of-quantitative-wall-motion-analysis-in-patients-with-acute-chest-pain-at-emergency-department
#2
Kyung-Hee Kim, Sang-Hoon Na, Jin-Sik Park
BACKGROUND: Evaluation of acute chest pain in emergency department (ED), using limited resource and time, is still very difficult despite recent development of many diagnostic tools. In this study, we tried to determine the applicability of new semi-automated cardiac function analysis tool, velocity vector imaging (VVI), in the evaluation of the patients with acute chest pain in ED. METHODS: We prospectively enrolled 48 patients, who visited ED with acute chest pain, and store images to analyze VVI from July 2005 to July 2007...
March 2017: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28399929/xanthogranulomatous-pyelonephritis-presenting-as-acute-pleuritic-chest-pain-a-case-report
#3
Justin Chow, Rameez Kabani, Kirstie Lithgow, Magdalena A Sarna
BACKGROUND: Xanthogranulomatous pyelonephritis is a rare and serious manifestation of chronic kidney inflammation that can be life-threatening if not recognized and treated appropriately, often with antibiotics and surgery. Affected patients are most commonly females in their fifth or sixth decade of life with a background of obstructive uropathy, nephrolithiasis, or recurrent urinary tract infections who present with vague nonspecific symptoms. CASE PRESENTATION: A 43-year-old woman of Russian ethnicity with a history of nephrolithiasis presented to our emergency department with new left-sided pleuritic chest pain amid a 6-week history of constitutional symptoms including fevers, night sweats, and 7 kg of weight loss...
April 12, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28392950/diffuse-subcutaneous-emphysema-and-pneumomediastinum-secondary-to-a-minor-blunt-chest-trauma
#4
Maximilian Andreas Storz, Eric P Heymann, Aristomenis K Exadaktylos
Full medical evaluation is paramount for all trauma patients. Minor traumas are often overlooked, as they are thought to bear low injury potential. In this case report, we describe the case of a 48-year-old man presenting to our Emergency Department with mild to moderate right-sided shoulder and scapular pain following a fall from his own height ten days previously. Clinical and paraclinical investigations (CT) revealed diffuse right shoulder pain, with crepitations on palpation of the neck, right shoulder, and right lateral chest wall...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28389572/prognostic-value-of-noninvasive-cardiovascular-testing-in-patients-with-stable-chest-pain-insights-from-the-promise-trial
#5
Udo Hoffmann, Maros Ferencik, James E Udelson, Michael H Picard, Quynh A Truong, Manesh R Patel, Megan Huang, Michael J Pencina, Daniel B Mark, John F Heitner, Christopher B Fordyce, Patricia A Pellikka, Jean-Claude Tardif, Matthew J Budoff, George Nahhas, Benjamin J Chow, Andrzej S Kosinski, Kerry L Lee, Pamela S Douglas
Background -Optimal management of patients with stable chest pain relies on the prognostic information provided by noninvasive cardiovascular testing, but there are limited data from randomized trials comparing anatomic with functional testing. Methods -In the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial, patients with stable chest pain and intermediate pre-test probability for obstructive coronary artery disease (CAD) were randomized to functional testing (exercise electrocardiography, nuclear stress, or stress echocardiography) or coronary computed tomography angiography (CTA)...
April 7, 2017: Circulation
https://www.readbyqxmd.com/read/28377021/triggers-and-timing-of-acute-coronary-syndromes
#6
Geoffrey H Tofler, Eran Kopel, Robert Klempfner, Michael Eldar, Thomas Buckley, Ilan Goldenberg
Previous studies have shown that an acute coronary syndrome (ACS) may be triggered by external activities; however, their frequency, predictors, and significance are uncertain. We evaluated data from the National Israel Survey of Acute Coronary Syndromes, which was conducted in 2004 (February to March) in all 25 coronary care units and cardiac wards in Israel. Demographic and clinical data were recorded for consecutive participants, including potential triggers and time of symptom onset of ACS. Among the 1,849 patients who completed the trigger question, 1/4 (25...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28375482/clinical-and-manometric-characteristics-of-patients-with-parkinson-s-disease-and-esophageal-symptoms
#7
A Su, R Gandhy, C Barlow, G Triadafilopoulos
Dysphagia is a common problem in patients with Parkinson's disease (PD); its etiology is multifactorial and its management is challenging. In this retrospective cohort analysis using prospectively collected data, we aimed to objectively characterize dysphagia and/or other esophageal symptoms in patients with PD, assess the prevalence of outflow obstruction as well as major or minor disorders of esophageal peristalsis leading to impaired esophageal clearance and highlight objective parameters that can help in the current management algorithm...
April 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28372866/increased-interarm-blood-pressure-difference-is-associated-with-autonomic-dysfunction-and-atherosclerosis-in-patients-with-chest-pain-and-no-history-of-coronary-artery-disease
#8
Hui-Jeong Hwang, Il Suk Sohn, Dong-Hee Kim, Chang-Bum Park, Jin-Man Cho, Chong-Jin Kim
OBJECTIVES: Interarm blood pressure (BP) difference has been reported to be associated with atherosclerosis and increased cardiovascular death. We were to investigate associations of interarm systolic blood pressure (SBP) difference with heart rate recovery (HRR) after exercise, an index of autonomic function, and carotid atherosclerotic markers, and to evaluate the association of interarm SBP difference with concurrent coronary artery disease (CAD). METHODS: A total of 995 consecutive patients who underwent treadmill stress echocardiography with chest pain but no history of CAD were enrolled...
March 20, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28363365/chest-wall-trauma
#9
REVIEW
Sarah Majercik, Fredric M Pieracci
Chest wall trauma is common, and contributes significantly to morbidity and mortality of trauma patients. Early identification of major chest wall and concomitant intrathoracic injuries is critical. Generalized management of multiple rib fractures and flail chest consists of adequate pain control (including locoregional modalities); management of pulmonary dysfunction by invasive and noninvasive means; and, in some cases, surgical fixation. Multiple studies have shown that patients with flail chest have substantial benefit (decreased ventilator and intensive care unit days, improved pulmonary function, and improved long-term functional outcome) when they undergo surgery compared with nonoperative management...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28357505/identification-of-left-ventricle-failure-on-pulmonary-artery-cta-diagnostic-significance-of-decreased-aortic-left-ventricle-enhancement
#10
Abhishek Chaturvedi, Joel P Thompson, Katherine Kaproth-Joslin, Susan K Hobbs, Karl Q Schwarz, Vijay K Krishnamoorthy, Apeksha Chaturvedi, Timothy Baran
PURPOSE: This study aimed to identify findings on non-ECG-gated CT pulmonary angiography (CTPA) indicating decreased left ventricle (LV) systolic function, later confirmed by echocardiogram. METHODS: After obtaining institutional review board approval, review was performed of emergency department (ED) patients who had CTPA and follow-up echocardiogram within 48 h, over 18 months. Patients with pulmonary embolus, suboptimal CTPA, arrhythmias or pericardial tamponade were excluded...
March 29, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28320636/the-significance-of-equivocal-exercise-treadmill-ecg-for-intermediate-risk-chest-pain-assessment-insight-from-coronary-ct-angiography-data
#11
Gary T E Lau, Henry Wei, Jo Wickham, Andrew C Y To
BACKGROUND: Exercise treadmill test (ETT) is commonly the first-line investigation in troponin-negative chest pain patients. Inconclusive results are common and often lead to repeated functional testings. Coronary computed tomographic angiography (CCTA) has excellent negative predictive value for coronary artery disease detection and may play an important role in their diagnostic workup. We aim to analyse ETT and CCTA findings to understand their modern roles in intermediate risk chest pain population with inconclusive ETT...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28298050/intra-articular-steroid-injection-for-frozen-shoulder
#12
Yaying Sun, Peng Zhang, Shaohua Liu, Hong Li, Jia Jiang, Shiyi Chen, Jiwu Chen
BACKGROUND: Intra-articular steroid injection is a common intervention for frozen shoulder (FS). PURPOSE: This review aimed to illustrate the effects of intra-articular steroid injection for FS. STUDY DESIGN: Systematic review and meta-analysis. METHODS: PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs) comparing intra-articular steroid injection with no injection or sham injections for FS...
October 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28297341/assessment-of-monte-carlo-algorithm-for-compliance-with-rtog-0915-dosimetric-criteria-in-peripheral-lung-cancer-patients-treated-with-stereotactic-body-radiotherapy
#13
Damodar Pokhrel, Sumit Sood, Rajeev Badkul, Hongyu Jiang, Christopher McClinton, Christopher Lominska, Parvesh Kumar, Fen Wang
The purpose of the study was to evaluate Monte Carlo-generated dose distributions with the X-ray Voxel Monte Carlo (XVMC) algorithm in the treatment of peripheral lung cancer patients using stereotactic body radiotherapy (SBRT) with non-protocol dose-volume normalization and to assess plan outcomes utilizing RTOG 0915 dosimetric compliance criteria. The Radiation Therapy Oncology Group (RTOG) protocols for non-small cell lung cancer (NSCLC) currently require radiation dose to be calculated using tissue density heterogeneity corrections...
May 2016: Journal of Applied Clinical Medical Physics
https://www.readbyqxmd.com/read/28290973/total-artificial-heart-implantation-as-a-bridge-to-heart-transplantation-in-an-active-duty-service-member-with-amyloid-cardiomyopathy
#14
Michael S Scully, Dylan E Wessman, James M McKee, Gregory M Francisco, Keshav R Nayak, Jon A Kobashigawa
INTRODUCTION: Cardiac involvement by light-chain (AL) amyloid occurs in up to 50% of patients with primary AL amyloidosis. The prognosis of amyloid heart disease is poor with 1-year survival rates of 35 to 40%. Historically, heart transplantation was considered controversial for patients with AL amyloid cardiomyopathy (CM) given the systemic nature of the disease and poor survival. We present a case report of an active duty service member diagnosed with advanced cardiac amyloid who underwent total artificial heart transplant as a bridge to heart transplant and eventual autologous stem cell transplant...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28285692/chest-wall-resection-for-non-small-cell-lung-cancer-a-case-matched-study-of-postoperative-pulmonary-function-and-quality-of-life
#15
Ming Liu, Jason A Wampfler, Jie Dai, Ruchi Gupta, Zhiqiang Xue, Shawn M Stoddard, Stephen D Cassivi, Gening Jiang, Ping Yang
BACKGROUND: To assess the pulmonary function and quality of life (QOL) after chest wall resection for non-small cell lung cancer. MATERIAL AND METHODS: One hundred and thirty-five patients (cases) who underwent pulmonary resection with chest wall removal were identified from January 1997 to December 2015. Propensity score matching (1:3) was applied to balance known confounders for pulmonary function and QOL between the cases and the control group who underwent pulmonary resection without chest wall invasion...
April 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/28270260/what-is-the-diagnostic-value-of-the-paediatric-exercise-tolerance-test-results-from-a-uk-centre
#16
Magdalena A Sajnach-Menke, Sarah C Walpole
Purpose The aim of this study was to determine whether the exercise tolerance test can provide diagnostic and prognostic information regarding children and young adults and help predict outcome. METHODS: A total of 87 patients, aged 7-29 years (median 13, mean 13.4) were selected retrospectively. They underwent exercise test at the Freeman Hospital from December, 2015 to May, 2016. There were two groups of patients - 46 had symptoms such as chest pain, palpitations, syncope, or dyspnoea on exertion and no cardiac diagnosis, and 40 patients had a cardiac diagnosis such as hypertrophic cardiomyopathy, transposition of the great arteries with post-arterial switch operation, aortic stenosis or regurgitation, tetralogy of Fallot, abnormal coronary arteries, Wolff-Parkinson-White syndrome, or supraventricular tachycardia...
March 8, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28266825/cardiovascular-disease-update-pulmonary-hypertension
#17
Johnathan D McDivitt, Craig Barstow
Pulmonary hypertension (PH) is a spectrum disorder with multiple causes of the elevation of pressure in the lungs. It often is difficult to diagnose because it mimics many commonly reported symptoms (eg, dyspnea, exercise intolerance, chest pain). Diagnosis is made via right heart catheterization; however, transthoracic echocardiography may show evidence of elevated pulmonary pressure as the first clue to the diagnosis. Diagnostic tests to consider include a liver panel, complete blood count, and thyroid function test; electrocardiogram; chest x-ray; pulmonary function testing; and possibly lung imaging via computed tomography scan or ventilation-perfusion scan...
March 2017: FP Essentials
https://www.readbyqxmd.com/read/28260354/overlap-of-gerd-and-gastrointestinal-functional-disorders
#18
Nicola De Bortoli, Veronica Natali, Sara Melissari, Natalia Simonetti, Gherardo Tapete, Santino Marchi
The functional gastrointestinal disorders (FGIDs) are common conditions with an overall prevalence burden estimated at approximately one-third of the population. These represent a heterogeneous group of conditions which may include both abnormal symptom perception and functional causes and seems to share similar trigger factors as food, lifestyle and psychological factor. GERD develops when the reflux of gastric contents into the esophagus leads to troublesome symptoms, with or without mucosal involvement. Functional heartburn represents a subcategory of patients who refers with heartburn but without abnormal esophageal acid exposure, abnormal number of reflux events or any temporal correlation between symptoms and reflux events, on the same hands these patients do not report any symptom relief during antisecretory treatment with proton pump inhibitors...
March 3, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28258851/longitudinal-2d-strain-can-help-diagnose-coronary-artery-disease-in-patients-with-suspected-non-st-elevation-acute-coronary-syndrome-but-apparent-normal-global-and-segmental-systolic-function
#19
Thibault Caspar, Hafida Samet, Mickaël Ohana, Philippe Germain, Soraya El Ghannudi, Samy Talha, Olivier Morel, Patrick Ohlmann
BACKGROUND: The clinical work-up of patients presenting with chest pain is a diagnostic challenge. We investigated the diagnostic performance of global (GLS) and territorial (TLS) longitudinal strain to predict coronary artery disease (CAD) in patients presenting with suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS) but apparent normal global and regional systolic function. METHODS: 150 consecutive suspected NSTE-ACS patients were initially screened for inclusion ; 58 patients with normal LVEF (≥55%) and WMSI (=1) were prospectively enrolled...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28254102/auricular-acupuncture-analgesia-in-thoracic-trauma-a-case-report
#20
Georgios S Papadopoulos, Petros Tzimas, Antonia Liarmakopoulou, Anastasios M Petrou
We report a case of thoracic trauma (rib fractures with pneumothorax and pulmonary contusions) with severe chest pain leading to ineffective ventilation and oxygenation. The patient presented to our emergency department. The patient had chronic obstructive pulmonary disease and was completely unable to take deep breaths and clear secretions from his bronchial tree. After obtaining informed consent, we applied auricular acupuncture to ameliorate pain and hopefully improve his functional ability to cough and breathe deeply...
January 2017: Journal of Acupuncture and Meridian Studies
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