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Chest Pain Center

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https://www.readbyqxmd.com/read/28197284/st-segment-elevation-myocardial-infarction-door-to-balloon-time-improvement-project
#1
Saad Al Bugami, Jamilah Alrahimi, Abdullah Almalki, Farqad Alamger, Ahmed Krimly, Wail Al Kashkari
BACKGROUND: The purpose of this quality improvement project was to evaluate prospectively the causes of delay for patients with acute ST-segment elevation myocardial infarction (STEMI) requiring primary percutaneous coronary intervention (PCI) upon arrival at the emergency department (ED) and implement recommendations to reduce delays and analyze the impact of recommendations to reduce the door-to-balloon (D2B) time in a newly established cardiac center (King Faisal Cardiac Center (KFCC))...
August 2016: Cardiology Research
https://www.readbyqxmd.com/read/28195937/an-updated-protocol-for-evaluating-chest-pain-and-managing-acute-coronary-syndromes
#2
Christopher R Kelly, Ajay J Kirtane, Jennifer Stant, Gregg W Stone, Robert M Minutello, S Chiu Wong, Honeyleen Manuzon, Roxanne Gerow-Smith, Nancy Kelley, LeRoy E Rabbani
Clinical pathways can optimize care both across and within institutions, but regular updates to these pathways based on new clinical trials, professional guidelines, and Food and Drug Administration approvals are essential. Herein we describe the most recent revisions to the New York-Presbyterian Hospital (Columbia University Medical Center and Weill Cornell Medical Center) clinical pathway for acute coronary syndromes and chest pain, which incorporates novel data regarding the timing and administration of P2Y12 inhibition (including the intravenous P2Y12 inhibitor cangrelor) and the appropriateness of prolonged (>1 year) dual antiplatelet therapy for the secondary prevention of ischemic events...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28187739/the-global-cardiovascular-magnetic-resonance-registry-gcmr-of-the-society-for-cardiovascular-magnetic-resonance-scmr-its-goals-rationale-data-infrastructure-and-current-developments
#3
Raymond Y Kwong, Steffen E Petersen, Jeanette Schulz-Menger, Andrew E Arai, Scott E Bingham, Yucheng Chen, Yuna L Choi, Ricardo C Cury, Vanessa M Ferreira, Scott D Flamm, Kevin Steel, W Patricia Bandettini, Edward T Martin, Leelakrishna Nallamshetty, Stefan Neubauer, Subha V Raman, Erik B Schelbert, Uma S Valeti, Jie Jane Cao, Nathaniel Reichek, Alistair A Young, Lyuba Fexon, Misha Pivovarov, Victor A Ferrari, Orlando P Simonetti
BACKGROUND: With multifaceted imaging capabilities, cardiovascular magnetic resonance (CMR) is playing a progressively increasing role in the management of various cardiac conditions. A global registry that harmonizes data from international centers, with participation policies that aim to be open and inclusive of all CMR programs, can support future evidence-based growth in CMR. METHODS: The Global CMR Registry (GCMR) was established in 2013 under the auspices of the Society for Cardiovascular Magnetic Resonance (SCMR)...
January 20, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28182138/construct-validity-of-the-depression-and-somatic-symptoms-scale-evaluation-by-mokken-scale-analysis
#4
Ya-Hsin Chou, Chin-Pang Lee, Chia-Yih Liu, Ching-I Hung
OBJECTIVE: Previous studies of the Depression and Somatic Symptoms Scale (DSSS), a free scale, have been based on the classical test theory, and the construct validity and dimensionality of the DSSS are as yet uncertain. The aim of this study was to use Mokken scale analysis (MSA) to assess the dimensionality of the DSSS. METHODS: A sample of 214 psychiatric outpatients with mood and anxiety disorders were enrolled at a medical center in Taiwan (age: mean [SD] =38...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28168514/limits-of-the-possible-diagnostic-image-quality-in-coronary-angiography-with-third-generation-dual-source-ct
#5
Marco M Ochs, Fabian Aus dem Siepen, Thomas Fritz, Florian Andre, Gitsios Gitsioudis, Grigorios Korosoglou, Sebastian Seitz, Yuriy Bogomazov, Christopher L Schlett, Roman Sokiranski, Andre Sommer, Friedemann Gückel, Matthias Brado, Hans-Ulrich Kauczor, Johannes Görich, Matthias G W Friedrich, Hugo A Katus, Sebastian J Buss
BACKGROUND: The usage of coronary CT angiography (CTA) is appropriate in patients with acute or chronic chest pain; however the diagnostic accuracy may be challenged with increased Agatston score (AS), increased heart rate, arrhythmia and severe obesity. Thus, we aim to determine the potential of the recently introduced third-generation dual-source CT (DSCT) for CTA in a 'real-life' clinical setting. METHODS: Two hundred and sixty-eight consecutive patients (age: 67 ± 10 years; BMI: 27 ± 5 kg/m²; 61% male) undergoing clinically indicated CTA with DSCT were included in the retrospective single-center analysis...
February 6, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28167641/prognostic-utility-of-a-modified-heart-score-in-chest-pain-patients-in-the-emergency-department
#6
James McCord, Rafael Cabrera, Bertil Lindahl, Evangelos Giannitsis, Kaleigh Evans, Richard Nowak, Tiberio Frisoli, Richard Body, Michael Christ, Christopher R deFilippi, Robert H Christenson, Gordon Jacobsen, Aitor Alquezar, Mauro Panteghini, Dina Melki, Mario Plebani, Franck Verschuren, John French, Garnet Bendig, Silvia Weiser, Christian Mueller
BACKGROUND: The TRAPID-AMI trial study (High-Sensitivity Troponin-T Assay for Rapid Rule-Out of Acute Myocardial Infarction) evaluated high-sensitivity cardiac troponin-T (hs-cTnT) in a 1-hour acute myocardial infarction (AMI) exclusion algorithm. Our study objective was to evaluate the prognostic utility of a modified HEART score (m-HS) within this trial. METHODS AND RESULTS: Twelve centers evaluated 1282 patients in the emergency department for possible AMI from 2011 to 2013...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28144607/clinical-utility-of-chest-computed-tomography-in-patients-with-rib-fractures-ct-chest-and-rib-fractures
#7
Brandon C Chapman, Douglas M Overbey, Feven Tesfalidet, Kristofer Schramm, Robert T Stovall, Andrew French, Jeffrey L Johnson, Clay C Burlew, Carlton Barnett, Ernest E Moore, Fredric M Pieracci
BACKGROUND: Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. OBJECTIVES: The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. METHODS: Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest...
December 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/28132542/-atypical-complaint-in-myocardial-ischaemia-belching
#8
Nóra Turi-Kováts, Hrisula Arabadzisz, András Zsoldos, János Tomcsányi
While educating non-medical personnel on acute coronary syndrome we often emphasize the importance of early recognition and urgent transfer to acute cardiac center of patients with acute myocardial infarction. Aside from typical symptoms of chest tightness and pain radiating to shoulder, arm and jaw, angina often presents with atypical, non-cardiac complaints. These symptoms, often suggesting gastrointestinal problems, can sometimes mislead even the most experienced physicians. We would like to present the case of an 83-year-old woman with several decades long history of ischaemic heart disease, who recently developed a new anginal symptom: lound, uncontrollable belching...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28130170/identifying-children-at-very-low-risk-for-blunt-intra-abdominal-injury-in-whom-ct-of-the-abdomen-can-be-avoided-safely
#9
Christian J Streck, Adam M Vogel, Jingwen Zhang, Eunice Y Huang, Matthew T Santore, Kuojen Tsao, Richard A Falcone, Melvin S Dassinger, Robert T Russell, Martin L Blakely
BACKGROUND: Computed tomography is commonly used to rule out intra-abdominal injury (IAI) in children, despite associated cost and radiation exposure. Our purpose was to derive a prediction rule to identify children at very low risk for IAI after blunt abdominal trauma (BAT) for whom a CT scan of the abdomen would be unnecessary. STUDY DESIGN: We prospectively enrolled children younger than 16 years of age who presented after BAT at 14 Level I pediatric trauma centers during 1 year...
January 24, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28090232/efficacy-and-safety-of-thrombolytic-therapy-in-acute-submassive-pulmonary-embolism-follow-up-study
#10
Santosh Kumar Sinha, Mohit Sachan, Amit Goel, Karandeep Singh, Vikas Mishra, Mukesh Jitendra Jha, Ashutosh Kumar, Nasar Abdali, Mohammad Asif, Mahamdula Razi, Umeshwar Pandey, Ramesh Thakur, Chandra Mohan Varma, Vinay Krishna
BACKGROUND: Thrombolysis in acute submassive pulmonary embolism (PE) remains controversial. So we studied impact of thrombolytic therapy in acute submassive PE in terms of mortality, hemodynamic status, improvement in right ventricular function, and safety in terms of major and minor bleeding. METHOD: A single-center, prospective, randomized study of 86 patients was conducted at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, India. Patients received thrombolysis (single bolus of tenecteplase) with unfractionated heparin (UFH, group I) or placebo with UFH (group II)...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28087310/clinical-features-and-three-year-outcomes-of-takotsubo-stress-cardiomyopathy-observational-data-from-one-center
#11
Sigita Glaveckaitė, Pranas Šerpytis, Dovilė Pečiūraitė, Roma Puronaitė, Nomeda Valevičienė
OBJECTIVE: The natural history, management, and outcome of Takotsubo (stress) cardiomyopathy (TTC) is not clear. The aim of this study was to investigate clinical features, define prognostic predictors, and assess the clinical course and outcomes of patients with TTC. METHODS: We analyzed 64 patients (52 women) meeting the proposed Mayo Clinic diagnostic criteria for TTC. All patients were treated at Vilnius University Hospital Santariskiu Klinikos from 2001-01-01 to 2014-11-27...
November 16, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28087181/challenging-the-99th-percentile-a-lower-troponin-cutoff-leads-to-low-mortality-of-chest-pain-patients
#12
Nils Arne Sörensen, Johannes Tobias Neumann, Francisco Ojeda, Tjark Schwemer, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Rule-out of non-ST-elevation myocardial infarction is based on consecutive measurements of cardiac troponins using the 99th percentile of the respective assay as cutoff. The new ESC guidelines alternatively offer rapid 1h algorithms with lower cutoffs than the 99th percentile for rule-out of non-ST-elevation myocardial infarction. We aimed to compare a recently introduced 1h algorithm based on a high-sensitivity cardiac troponin I (hs-TnI) cutoff of 6ng/L at 0h and 1h to the current standard of care using the 99th percentile (27ng/L) as cutoff with reference to follow-up events in a large chest pain cohort...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28048800/su-f-t-112-long-term-follow-up-of-nsclc-patients-treated-with-lung-sbrt-using-the-modified-conformal-arc-mdca-planning-technique
#13
E Ku, A Desai, D Fang, C Lawrence, C Iannuzzi, C Shi
PURPOSE: To assess long-term toxicity and primary tumor changes for Stage I/II non-small cell lung carcinoma (NSCLC) patients after treatment with lung SBRT using the modified dynamic conformal arc (MDCA) planning technique. METHODS: Clinical and radiograph data from electronic health records of 15 NSCLC patients treated with lung SBRT utilizing the MDCA technique between October 2011 and July 2014 were retrospectively reviewed. MDCA uses a coplanar beam arrangement, patient body center for the beam isocenter, and six partial rotation conformal arcs to target the tumor...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28033243/prognostic-values-of-4-risk-scores-in-chinese-patients-with-chest-pain-prospective-2-centre-cohort-study
#14
MULTICENTER STUDY
Xiao-Hui Chen, Hui-Lin Jiang, Yun-Mei Li, Cangel Pui Yee Chan, Jun-Rong Mo, Chao-Wei Tian, Pei-Yi Lin, Colin A Graham, Timothy H Rainer
Four risk scores for stratifying patients with chest pain presenting to emergency departments (EDs) (namely Thrombolysis in myocardial infarction [TIMI], Global registry for acute coronary events [GRACE], Banach and HEART) have been developed in Western settings but have never been compared and validated in Chinese patients. We aimed to find out to the number of MACE within 7 days, 30 days, and 6 months after initial ED presentation, and also to compare the prognostic performance of these scores in Chinese patients with suspected cardiac chest pain (CCP) to predict 7-day, 30-day, and 6-month major adverse cardiac events (MACE)...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28000002/stress-perfusion-magnetic-resonance-imaging-to-detect-coronary-artery-lesions-in-children
#15
Chodchanok Vijarnsorn, Michelle Noga, Daryl Schantz, Dion Pepelassis, Edythe B Tham
BACKGROUND: Stress perfusion cardiovascular magnetic resonance (CMR) is used widely in adult ischemic heart disease, but data in children is limited. We sought to evaluate feasibility, accuracy and prognostic value of stress CMR in children with suspected coronary artery disease (CAD). METHODS: Stress CMR was reviewed from two pediatric centers over 5 years using a standard pharmacologic protocol. Wall motion abnormalities, perfusion deficits and late enhancement were correlated with coronary angiogram (CAG) when available, and clinical status at 1 year follow-up for major adverse cardiovascular events (MACE; coronary revascularization, non-fatal myocardial infarction and death due to CAD) was recorded...
December 20, 2016: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/27989537/delayed-cardiac-tamponade-a-rare-but-life-threatening-complication-of-catheter-ablation
#16
Elizabeth Yetter, Jared Brazg, Diane Del Valle, Laura Mulvey, Eitan Dickman
Delayed cardiac tamponade (DCT) is a rare and life-threatening complication of catheter ablation performed as a treatment of atrial fibrillation, with few cases described in the medical literature. We present the case of a 57year-old man presenting with DCT 61days following a catheter ablation procedure. To the best of our knowledge, this is the most delayed case of cardiac tamponade (CT) following catheter ablation described in the literature. We also discuss the importance of point of care ultrasound (POCUS) in the diagnosis and treatment of CT...
November 17, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27979023/rate-of-recurrent-anaphylaxis-and-associated-risk-factors-among-olmsted-county-minnesota-residents-a-population-based-study
#17
Sangil Lee, Curtis Bashore, Christine M Lohse, M Fernanda Bellolio, Alanna Chamberlain, Kumi Yuki, Erik P Hess, Ronna L Campbell
BACKGROUND: The rate and risk factors for recurrence of anaphylaxis are not well known. OBJECTIVE: To measure the rate and risk factors for recurrent anaphylaxis in a population-based cohort in Olmsted County, Minnesota. METHODS: We conducted a population-based cohort study using the Rochester Epidemiology Project, a comprehensive medical records linkage system, to obtain records of patients who presented to medical centers within the Olmsted County area with anaphylaxis from January 1, 2001, through December 31, 2010...
December 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27970272/tct-109-predictive-performance-of-high-sensitivity-cardiac-troponin-i-for-all-cause-death-is-affected-by-cut-off-value-in-patients-enrolled-in-chest-pain-center-at-emergency-department
#18
Il Park, Jin-Ho Choi, Namjoon Kim, Young-Do Jeon, Ji-Sun Choi, Jeong Hoon Yang, Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Sang Hoon Lee
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27914587/outcomes-of-chest-wall-resections-in-pediatric-sarcoma-patients
#19
Carmen Lopez, Arlene Correa, Ara Vaporciyan, Mary Austin, David Rice, Andrea Hayes-Jordan
PURPOSE: Chest wall tumors in pediatric patients are rare. This study evaluates outcomes in pediatric patients who have undergone chest wall resections secondary to sarcomas. METHODS: A retrospective review was performed for patients <19years old who underwent chest wall resections for sarcoma 1999-2014 at the University of Texas MD Anderson Cancer Center. RESULTS: Of 44 patients, Ewing's sarcoma (n=18) and osteosarcoma (n=16) were most common...
January 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27852221/non-coronary-chest-pain-does-not-affect-long-term-mortality-a-prospective-observational-study-using-a-matched-population-control
#20
Staffan Nilsson, Petter Järemo
BACKGROUND: Chest pain assumed to be of non-coronary origin (NCCP) may be linked to enhanced mortality due to coronary heart disease (CHD). The aim of this study was to follow NCCP patients, as defined in primary care, with respect to mortality and long-term morbidity of CHD. We further examined if NCCP associates with risk factors for CHD. METHODS: Patients consulting general practitioners (GPs) in 1998-2000 in three primary care centers in the southeast Sweden for chest pain regarded as NCCP were compared with controls matched for age, gender and residential area...
November 16, 2016: BMC Family Practice
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