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Functional chest pain

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https://www.readbyqxmd.com/read/28646858/reasons-for-encounter-by-different-levels-of-urgency-in-out-of-hours-emergency-primary-health-care-in-norway-a-cross-sectional-study
#1
Guttorm Raknes, Steinar Hunskaar
BACKGROUND: Frequencies of reasons for encounter (RFEs) in emergency primary care out-of-hours (OOH) services are relevant for planning of capacities as well as to target the training of staff at casualty clinics. We aimed to present frequencies of RFEs in the different organ systems, and to identify the most frequent RFEs at different urgency levels. METHODS: We analyzed data on RFEs in Norwegian OOH services. International Classification of Primary Care (ICPC-2) RFE codes were recorded in all contacts to eight representative OOH casualty clinics in 2014 and 2015 covering 20 municipalities with a total population of 260 196...
June 24, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28625240/-dynamic-changes-of-complement-level-in-patients-with-acute-coronary-syndrome-and-its-relationships-with-myocardial-injury
#2
Aihong Shao, Xin Qi, Qi Li, Wenjun Jia, Liping Wei, Wenguang Hou, Yanfang Qi, Yue Liu
OBJECTIVE: To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). METHODS: A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28623036/-arrhythmogenic-right-ventricular-cardiomyopathy-dysplasia-literature-review-and-case-report
#3
William Alejandro Camargo-Ariza, Silvia Juliana Galvis-Blanco, Tatiana Del Pilar Camacho-Enciso, Carlos Alberto Quiroz-Romero, Juan José Bermudez-Echeverry
Arrhythmogenic right ventricular cardiomyopathy/dysplasia is an inherited autosomal dominant pathology with an estimated prevalence of 1:2,500 to 1:5,000, being higher in males (3:1). It is characterized histologically by replacement of cardiomyocytes by fibro-adipose tissue, which predisposes to ventricular arrhythmias, right ventricular failure, and sudden cardiac death. The main goal of treatment is to reduce the risk of sudden death and improve the quality of life of patients. We present the case of a 23 year old woman whose clinical symptoms started with palpitations, chest pain with physical activity, syncope and headache 6 years ago during her first pregnancy...
June 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28621042/clinical-evaluation-of-anomalous-aortic-origin-of-a-coronary-artery-aaoca
#4
Silvana Molossi, Hitesh Agrawal
The clinical evaluation of patients with an anomalous aortic origin of a coronary artery (AAOCA), a congenital abnormality of the origin or course of a coronary artery that arises from the aorta, is challenging given its first presentation being sudden cardiac arrest in about half of the patients. Symptoms of chest pain, shortness of breath and syncope during exertion should be of concern in evaluating young athletes and nonathletes. The lack of abnormal signs on the physical exam and electrocardiogram further adds to the difficulty in establishing the diagnosis...
June 16, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28616378/primary-ciliary-dyskinesia-presenting-with-spontaneous-pneumothorax-case-report-and-review-of-the-literature
#5
Jia Hou, Yanan Zhang, Ri Gong, Xiwei Zheng, Xia Yang
BACKGROUND: Primary ciliary dyskinesia (PCD) is an autosomal recessive heterogeneous group of conditions with variable clinical findings. CASE PRESENTATION: A 36-year-old nonsmoking Chinese man present to the emergency department of our hospital with acute-onset breathlessness and sudden-onset left-sided chest pain. The patient had 6 years primary infertility and suffered from recurrent episodes of respiratory tract infections since childhood. Chest X-ray was performed, which showed a left-sided pneumothorax with lung collapse...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28616302/esophagogastric-junction-outflow-obstruction-related-functional-chest-pain-treated-using-robotic-assisted-thoracoscopic-esophageal-myotomy
#6
Kuan-Hsun Lin, Shih-Chun Lee, Tsai-Wang Huang, Hsu-Kai Huang
Elevated relaxation pressure in combination with intact or weak peristalsis characterizes esophagogastric junction (EGJ) outflow obstruction. Symptoms of EGJ outflow obstruction include dysphagia and atypical chest pain. EGJ outflow obstruction can be diagnosed using high-resolution manometry (HRM), but there is a lack of consensus regarding treatment. We present a case report of a 43-year-old man with a history of headache and mitral valve disorder who suffered from intermittent atypical chest pain for 20 years...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28613283/risk-factors-for-no-reflow-phenomenon-after-percutaneous-coronary-intervention-in-patients-with-acute-coronary-syndrome
#7
Tian Liang, Min Liu, Chengyu Wu, Qing Zhang, Lei Lu, Zhongliang Wang
BACKGROUND: To explore risk factors for no-reflow phenomenon after percutaneous coronary intervention in patients with acute coronary syndrome. METHODS: A total of 733 acute myocardial infarction patients with persistent ischemic chest pain within 12 or 12-24 hours after onset received emergency percutaneous coronary intervention. Patients were divided into a normal reflow group and a no-reflow group, according to TIMI grading and myocardial blush grading after percutaneous coronary intervention...
May 2017: Revista de Investigación Clínica; Organo del Hospital de Enfermedades de la Nutrición
https://www.readbyqxmd.com/read/28606947/new-promises-for-refining-risk-stratification-from-anatomical-and-functional-assessment-of-stable-chest-pain
#8
EDITORIAL
Leslee J Shaw, G B John Mancini
No abstract text is available yet for this article.
June 13, 2017: Circulation
https://www.readbyqxmd.com/read/28605043/typical-angina-is-associated-with-greater-coronary-endothelial-dysfunction-but-not-abnormal-vasodilatory-reserve
#9
Ahmed AlBadri, Derek Leong, C Noel Bairey Merz, Janet Wei, Eileen M Handberg, Chrisandra L Shufelt, Puja K Mehta, Michael D Nelson, Louise E Thomson, Daniel S Berman, Leslee J Shaw, Galen Cook-Wiens, Carl J Pepine
BACKGROUND: Typical angina (TA) is defined as substernal chest pain precipitated by physical exertion or emotional stress and relieved with rest or nitroglycerin. Women and elderly patients are usually have atypical symptoms both at rest and during stress, often in the setting of nonobstructive coronary artery disease (CAD). HYPOTHESIS: To further understand this, we performed subgroup analysis comparing subjects who presented with TA vs nontypical angina (NTA) using baseline data of patients with nonobstructive CAD and coronary microvascular dysfunction (CMD) enrolled in a clinical trial...
June 12, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28599831/alterations-in-cardiac-deformation-timing-of%C3%A2-contraction-and-relaxation-and-early-myocardial-fibrosis-accompany-the-apparent-recovery-of-acute-stress-induced-takotsubo-cardiomyopathy-an-end-to-the-concept-of%C3%A2-transience
#10
Konstantin Schwarz, Trevor Ahearn, Janaki Srinivasan, Christopher J Neil, Caroline Scally, Amelia Rudd, Baljit Jagpal, Michael P Frenneaux, Cristina Pislaru, John D Horowitz, Dana K Dawson
BACKGROUND: Takotsubo syndrome is an increasingly recognized cause of chest pain and occasionally of cardiogenic shock. Despite rapid improvement of the left ventricular (LV) ejection fraction, recent registry data raise concerns about long-term prognosis. The aim of this study was to test the hypothesis that restoration of normal ejection fraction after acute takotsubo syndrome is not equivalent to full functional recovery. METHODS: Fifty-two patients with takotsubo syndrome (according to the Mayo Clinic criteria plus cardiac magnetic resonance imaging to exclude myocardial infarction) and 44 healthy control subjects of the same age, gender, and cardiovascular comorbidity distribution were prospectively recruited...
June 6, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28598047/awareness-and-outcome-of-changing-trends-in-clinical-profile-of-dengue-fever-a-retrospective-analysis-of-dengue-epidemic-from-january-to-december-2014-at-a-tertiary-care-hospital
#11
Jitendra Singh, Anju Dinkar, Virendra Atam, D Himanshu, Kamlesh Kumar Gupta, Kauser Usman, Ravi Misra
BACKGROUND: Dengue fever is caused by mosquito-borne arboviral infection that has become a public health concern globally. Recently, an alarming rise of dengue has also been seen in India. Hence the study was undertaken to know profile of clinical manifestations and laboratory findings during the evolution of dengue fever. METHODS: In this study, retrospective data analysis was done in 216 seropositive dengue patients admitted between January to December 2014 in department of medicine at a north Indian care hospital...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28597214/-diagnosis-of-ischemia-and-revascularization-in-patients-with-ventricular-tachyarrhythmia
#12
REVIEW
Thomas Deneke, Carsten W Israel
Sustained ventricular tachyarrhythmia usually occurs on the basis of structural heart disease, particularly coronary heart disease (CAD). Although monomorphic ventricular tachycardia (VT) appears mainly in patients with CAD, it is typically not triggered by acute ischemia, in contrast to polymorphic VT or ventricular fibrillation (VF). To judge if VT is caused by acute ischemia is even more difficult in context with an elevated highly sensitive troponin T which is generally elevated in sustained VT because tachycardia in chronic stable coronary artery sclerosis causes a mismatch between increased oxygen demand and limited oxygen supply...
June 8, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28592440/rome-foundation-asian-working-team-report-asian-functional-gastrointestinal-disorder-symptom-clusters
#13
Kewin Tien Ho Siah, Xiaorong Gong, Xi Jessie Yang, William E Whitehead, Minhu Chen, Xiaohua Hou, Nitesh Pratap, Uday C Ghoshal, Ari F Syam, Murdani Abdullah, Myung-Gyu Choi, Young-Tae Bak, Ching-Liang Lu, Sutep Gonlachanvit, Chua Seng Boon, Fan Fang, Pui Kuan Cheong, Justin C Y Wu, Kok-Ann Gwee
OBJECTIVE: Functional gastrointestinal disorders (FGIDs) are diagnosed by the presence of a characteristic set of symptoms. However, the current criteria-based diagnostic approach is to some extent subjective and largely derived from observations in English-speaking Western patients. We aimed to identify latent symptom clusters in Asian patients with FGID. DESIGN: 1805 consecutive unselected patients with FGID who presented for primary or secondary care to 11 centres across Asia completed a cultural and linguistic adaptation of the Rome III Diagnostic Questionnaire that was translated to the local languages...
June 7, 2017: Gut
https://www.readbyqxmd.com/read/28591063/a-new-technique-for-lipid-core-plaque-detection-by-optical-coherence-tomography-for-prevention-of-peri-procedural-myocardial-infarction-a-case-report
#14
Yongcheol Kim, Muthukaruppan Gnanadesigan, Gijs van Soest, Thomas W Johnson
RATIONALE: Percutaneous coronary intervention (PCI) provides effective revascularization of atherosclerotic coronary arteries but the invasive nature of treatment can result in complications. PATIENT CONCERNS: A 53-year old man underwent coronary angiography due to chest pain with minimal ST-segment elevation in the inferior leads of the electrocardiogram. DIAGNOSIS: We proceeded directly to coronary angiography and delineated a moderate stenosis with haziness in the mid right coronary artery (RCA)...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28587125/equine-welfare-during-exercise-an-evaluation-of-breathing-breathlessness-and-bridles
#15
REVIEW
David J Mellor, Ngaio J Beausoleil
Horses engaged in strenuous exercise display physiological responses that approach the upper functional limits of key organ systems, in particular their cardiorespiratory systems. Maximum athletic performance is therefore vulnerable to factors that diminish these functional capacities, and such impairment might also lead to horses experiencing unpleasant respiratory sensations, i.e., breathlessness. The aim of this review is to use existing literature on equine cardiorespiratory physiology and athletic performance to evaluate the potential for various types of breathlessness to occur in exercising horses...
May 26, 2017: Animals: An Open Access Journal From MDPI
https://www.readbyqxmd.com/read/28584311/takotsubo-cardiomyopathy-in-the-case-of-72-year-old-teacher-after-work-related-psychological-stress-evolution-of-left-ventricular-longitudinal-strain-delayed-but-complete-recovery-in-automated-function-imaging-afi
#16
Karina Wierzbowska-Drabik, Andrzej Marcinkiewicz, Piotr Hamala, Ewa Trzos, Piotr Lipiec, Małgorzata Kurpesa, Radosław Kręcki, Michał Plewka, Jarosław D Kasprzak
Takotsubo cardiomyopathy (TC) is related to a transient systolic dysfunction of left ventricle (LV), accompanied by clinical and electrocardiographic symptoms of myocardial ischemia in the absence of hemodynamically significant coronary artery disease. Takotsubo cardiomyopathy is usually provoked by a psychologically or/and physically stressful event which may be related to occupational activities. Although visually assessed evolution of LV function is well documented, the data concerning strain changes is sparse and various patterns of deformation abnormalities are suggested...
March 23, 2017: International Journal of Occupational Medicine and Environmental Health
https://www.readbyqxmd.com/read/28575245/peroral-endoscopic-myotomy-versus-surgical-myotomy-for-primary-achalasia-single-center-retrospective-analysis-of-74-patients
#17
S de Pascale, A Repici, F Puccetti, E Carlani, R Rosati, U Fumagalli
Achalasia is a neurodegenerative motility disorder of the esophagus; dysphagia, weight loss, chest pain, and regurgitation are its main symptoms. Surgical myotomy (HM) is considered the gold standard treatment. However, peroral endoscopic myotomy (POEM) seems to be a safe and effective alternative option. The aim of this study is to compare the safety and efficacy of these techniques. From March 2012 to June 2015, 74 patients with symptomatic primary achalasia underwent myotomy. The two groups were compared in terms of intraoperative and postoperative outcomes and Eckardt score at last follow-up...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28574936/coronary-microcirculatory-dysfunction-in-human-cardiomyopathies-a-pathologic-and-pathophysiologic-review
#18
Kristina Selthofer-Relatic, Martina Mihalj, Aleksandar Kibel, Ana Stupin, Marko Stupin, Ivana Jukic, Akos Koller, Ines Drenjancevic
Cardiomyopathies are a heterogeneous group of diseases of the myocardium. The term cardiomyopathy involves a wide range of pathogenic mechanisms that affect the structural and functional states of cardiomyocytes, extravascular tissues, and coronary vasculature, including both epicardial coronary arteries and the microcirculation. In the developed phase, cardiomyopathies present with various clinical symptoms: dyspnea, chest pain, palpitations, swelling of the extremities, arrhythmias, and sudden cardiac death...
July 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28571183/effect-of-ranolazine-in-patients-with-chest-pain-and-normal-coronaries-a-hospital-based-study
#19
Swapan Saha, Tony Ete, Manish Kapoor, Pravin Kumar Jha, Rinchin Dorjee Megeji, Gaurav Kavi, Synrang Batngen Warjri, Animesh Mishra
INTRODUCTION: There is an important role of coronary microcirculation in the clinical presentation and prognosis of patients who have typical chest pain despite normal epicardial coronary arteries (microvascular angina). Treatment of these patients is empirical because of the incomplete knowledge of its cause. Limited data has shown that ranolazine reduces angina and improves exercise performance in such patients with frequent angina. AIM: To evaluate the effect of ranolazine in patients with chest pain and normal epicardial coronaries (micro-vascular angina)...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28570317/safety-of-nebulized-epinephrine-in-smoke-inhalation-injury
#20
Guillermo Foncerrada, Francisco Lima, Robert P Clayton, Ronald P Mlcak, Perenlei Enkhbaatar, David N Herndon, Oscar E Suman
This pilot study was conducted to profile safety of nebulized racemic epinephrine when used as a therapy for smoke inhalation injury in severely burned children. We enrolled 16 patients who were 7 to 19 years of age ([mean ± SD], 12 ± 4 years) with burns covering more than 30% of the TBSA (55 ± 17%) and smoke inhalation injury, as diagnosed by bronchoscopy at burn center admission. Patients were randomized to receive either standard of care (n = 8), which consisted of nebulized acetylcysteine, nebulized heparin, and nebulized albuterol, or to receive standard of care plus nebulized epinephrine (n = 8)...
May 16, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
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