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“Acute chest pain”

Stephen Landy, Sagar Munjal, Elimor Brand-Schieber, Alan M Rapoport
BACKGROUND: In a previous randomized, double-blind, proof-of-concept study in rapidly escalating migraine, a 3 mg dose of subcutaneous sumatriptan (DFN-11) was associated with fewer and shorter triptan sensations than a 6 mg dose. The primary objective of the study was to assess the efficacy and safety of acute treatment with DFN-11 compared with placebo in episodic migraine. METHODS: This was a multicenter, randomized, double-blind, placebo-controlled efficacy and safety study of DFN-11 in the acute treatment of adults with episodic migraine (study RESTOR)...
August 15, 2018: Journal of Headache and Pain
Georgi Kotov, Iva N Dimitrova, Alexandar Iliev, Violeta Groudeva
The azygos lobe is a rare anatomical variant, most often encountered in the right lung. Its etiology is related to a defect of the migration of the azygos vein during the embryonic development. Here, we describe a rare case of an azygos lobe of the right lung, diagnosed incidentally on a computed tomography (CT) scan in a 40-year-old male patient who presented with chest pain, shortness of breath, and fever. The initial differential diagnosis included acute myocardial infarction, aortic dissection, and myocarditis...
June 11, 2018: Curēus
Emre Aslanger, Özlem Yıldırımtürk, Emrah Bozbeyoğlu, Barış Şimşek, Can Yücel Karabay, Ayça Türer Cabbar, Ömer Kozan, Muzaffer Değertekin
Benign variant (BV) ST-segment elevation (STE) is present in anterior chest leads in most individuals and may cause diagnostic confusion in patients presenting with chest pain. Recently, 2 regression formulas were proposed for differentiation of BV-STE from anterior ST-elevation myocardial infarction (MI) on the electrocardiogram, computation of which is heavily device-dependent. We hypothesized that a simpler visual-assessment-based formula, namely (R-wave amplitude in lead V4 + QRS amplitude in V2) - (QT interval in millimeters + STE60 in V3), will be noninferior to these formulas...
July 19, 2018: American Journal of Cardiology
Saleema Allana, Dr Debra K Moser, Dr Tazeen Saeed Ali, Dr Aamir Hameed Khan
BACKGROUND: Patients' experience of acute coronary syndrome (ACS) symptoms is important in determining their prehospital delay. OBJECTIVE: To explore gender differences in acute symptoms of ACS, knowledge about the symptoms, their attribution, and perception of urgency, among Pakistani ACS patients. METHODS: Comparative, cross-sectional study design with 249 ACS patients. RESULTS: The most commonly reported symptoms were ghabrahat (fidgetiness), chest pain, and chest heaviness...
August 11, 2018: Heart & Lung: the Journal of Critical Care
Yusuke Watanabe, Toru Naganuma, Yosuke Kitanaka, Sunao Nakamura
A 70-year-old woman with substernal chest pain lasting 2.5 h presented to the emergency department of our hospital. She had a history of aortic valve replacement with the Freestyle stentless aortic bioprosthesis for severe aortic regurgitation 7 years ago. The initial electrocardiogram showed sinus rhythm at a rate of 71 bpm with ST-segment slight elevation in leads II, III and aVF. She was diagnosed as having acute coronary syndrome and was referred for an urgent catheterization. Urgent coronary angiography revealed total occlusion in the distal segment of the right coronary artery...
August 10, 2018: European Journal of Cardio-thoracic Surgery
Javier García-Niebla, Andrés Ricardo Pérez-Riera, Raimundo Barbosa-Barros, Jorge Díaz-Muñoz, Rodrigo Daminello-Raimundo, Luiz Carlos de Abreu, Kjell Nikus
Right ventricular involvement in inferior myocardial infarction is a marker of poor prognosis. We present a case of a 62-year-old man with very recent onset of acute chest pain and cardiac shock with the triad of elevated jugular venous pressure, distension of the jugular veins on inspiration, and clear lung fields. In addition, the admission electrocardiogram showed a slurring J wave or lambda-like wave and conspicuous ST segment depression in several leads, predominantly in the lateral precordial (V4-V6), all clinical-electrocardiographic features of ominous prognosis...
August 14, 2018: Annals of Noninvasive Electrocardiology
Jason J Sico, Fitsum Baye, Laura J Myers, John Concato, Jared Ferguson, Eric M Cheng, Farid Jadbabaie, Zhangsheng Yu, Gregory Arling, Alan J Zillich, Mathew J Reeves, Linda S Williams, Dawn M Bravata
Background: American Heart Association/American Stroke Association expert consensus guidelines recommend consideration of cardiac stress testing to screen for occult coronary heart disease (CHD) among patients with ischemic stroke/TIA who have a high-risk Framingham Cardiac Risk Score (FCRS). Whether this guideline is being implemented in routine clinical practice, and the association of its implementation with mortality, is less clear. Methods: Study participants were Veterans with stroke/TIA (n = 11,306) during fiscal year 2011 who presented to a VA Emergency Department or who were admitted...
June 2018: Neurology. Clinical Practice
Camilla Strøm, Jakob S Stefansson, Maria Louise Fabritius, Lars S Rasmussen, Thomas A Schmidt, Janus C Jakobsen
BACKGROUND: Short-stay units are hospital units that provide short-term care for selected patients. Studies have indicated that short-stay units might reduce admission rates, time of hospital stays, hospital readmissions and expenditure without compromising the quality of care. Short-stay units are often defined by a target patient category, a target function, and a target time frame. Hypothetically, short-stay units could be established as part of any department, but this review focuses on short-stay units that provide care for participants with internal medicine diseases and conditions...
August 13, 2018: Cochrane Database of Systematic Reviews
Ahmed Abuosa, Jamilah AlRahimi, Nasir Mansour, Ashar Bilal, Atif AlQabbani, Akram Neyaz
A case of a young Saudi patient with a previous diagnosis of bronchial asthma, nasal polyps, and chronic smoker, presented with atypical chest pain, elevated serum troponin and borderline ischemic electrocardiogram (ECG) changes, with no significant regional wall motion abnormalities at bedside echocardiography is reported. The patient was admitted to the coronary care unit for continuous monitoring as possible acute coronary syndrome, non-ST elevation myocardial infarction (STEMI). One hour after admission, the patient had ventricular fibrillation (VF) cardiac arrest that required three DC shocks and amiodarone bolus before returning of spontaneous circulation, which followed the fourth shock...
October 2018: Journal of the Saudi Heart Association
Juliet Aaferemwin Yirerong, Heather Hurlburt
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute myocardial infarction of emerging significance, which occurs predominantly in young women without coronary artery disease risk factors. Valsalva-like activities such as coughing have been identified as potential triggers for the development of SCAD. We report a case of SCAD in a man in whom the only identifiable predisposing factor was excessive coughing. He presented with atypical chest pain. Troponin I peaked at 29 ng/mL, and ECG showed no evidence of ischaemic changes...
August 9, 2018: BMJ Case Reports
Masanori Shimomura, Shunta Ishihara, Masashi Iwasaki
BACKGROUND: In rare cases, rheumatoid pleural nodules can rupture into the pleural cavity to cause pneumothorax or empyema. We report successful surgical treatment of a patient with an intractable secondary pneumothorax due to rupture of a subpleural rheumatoid nodule into the pleural cavity. CASE PRESENTATION: A 75-year-old man with a medical history of rheumatoid arthritis, acute coronary syndrome, and diabetes was admitted to our hospital because of left chest pain and dyspnea...
August 8, 2018: Surgical Case Reports
Ali Zakaria, Bayan Al Share, Georgy Kaspar, Delano Small
Acute coronary syndrome (ACS) is a term used to describe a spectrum of diseases associated with sudden reduced blood flow to the heart. Coronary artery thromboembolism is recognized as an important nonatherosclerotic cause of acute myocardial infarctions in 2.9% of ACS cases, with a long-term outcome indicating that coronary embolism patients represent a high-risk subpopulation. There are various risk factors for developing a coronary thromboembolism, with atrial fibrillation being the most frequently reported cause...
March 2018: Journal of Family Medicine and Primary Care
Laura Seese, Arman Kilic, Forozan Navid, Thomas G Gleason, Ibrahim Sultan
A 68-year-old male presented with complaints of right-sided neck and chest pain with systolic blood pressures >200mmHg but denied any recent blunt trauma or whiplash events. A computer tomography angiography (CTA) demonstrated an acute dissection involving the origin of the right brachiocephalic artery that extended into the right common carotid and right subclavian arteries. The patient was neurologically intact and CTA of the brain demonstrated a stable arachnoid cyst and a brain perfusion scan demonstrated homogenous perfusion...
August 3, 2018: Annals of Thoracic Surgery
Fabio Ramponi, Theone Papps, James Edwards
Patients presenting with acute onset of chest pain require prompt diagnosis and rapid establishment of a management plan. Acute aortic dissection and acute pulmonary embolism are life-threatening emergencies that can mimic each other at presentation. Correct identification of this uncommon scenario is crucial to initiate the appropriate interventions. The authors present a unique case of concomitant acute type A aortic dissection and acute saddle pulmonary embolism; the patient underwent successful aortic repair and pulmonary embolectomy...
February 2018: Aorta (Stamford, Conn.)
Xue-Qing Yang, Hai-Yan Zhu, Xian Wang, Huai-Bing Zhao, Wei Zhang, Min Xiao, Li-Jing Zhang
RATIONALE: Spontaneous coronary artery dissection is a highly unusual cause of acute coronary disease. It is a result of a hematoma formation within the outer third of the tunica media,with subsequent expansion leading to compression of the true lumen and resultant myocardial ischemia. PATIENT CONCERNS: We present a case of a middle-aged woman presenting with chest pain with acute anterior myocardial infarction, who did not reveal any of the cardiovascular risk factors...
August 2018: Medicine (Baltimore)
Besharat Rahimi, Behdad Boroofeh, Roshan Dinparastisaleh, Hale Nazifi
Background: Vertebroplasty is a procedure most commonly used for vertebral compression fractures. Although it is a relatively safe procedure, complications have been reported. Cement embolism is seen in 2.1%-26% of patients after percutaneous vertebroplasty. Case presentation: a 38-year-old male who was diagnosed with cushing's syndrome, underwent percutaneous vertebroplasty for his thoracic osteoporotic compression fractures. 24-hours following vertebroplasty, he presented to emergency department with acute-onset dyspnea and chest pain...
2018: Respiratory Medicine Case Reports
Neelima Singh, Vedika Rathore, Roshan Kumar Mahat, Puneet Rastogi
Cardiac markers are used to evaluate functions of heart. However, there are no satisfactory cardiac biomarkers for the diagnosis of acute myocardial infarction (AMI) within 4 h of onset of chest pain. Among novel cardiac markers, glycogen phosphorylase BB (GPBB) is of particular interest as it is increased in the early hours after AMI. The present study was conducted with the objective to find out the sensitivity and specificity of GPBB over other cardiac markers i.e. myoglobin and CKMB in patients of AMI within 4 h after the onset of chest pain...
July 2018: Indian Journal of Clinical Biochemistry: IJCB
Yasuhiro Tanabe, Takeshi Yamamoto, Teppei Murata, Kei Mabuchi, Nobuhiro Hara, Atsushi Mizuno, Toshihiro Nozato, Shinji Hisatake, Toru Obayashi, Morimasa Takayama, Ken Nagao
Gender differences in patients with acute pulmonary embolism (APE) remain unclear and controversial. We aimed to understand the gender differences in patients with APE treated in the cardiovascular care units. The registry database of 1,428 patients with APE treated at the Tokyo cardiovascular care unit Network institutions from 2010 to 2014 was retrieved for analysis. In all, 795 women (55.7%) and 633 men (44.3%) were included in this study. The women were older than men (68.0 ± 16.1 vs 60.9 ± 15.6 years, p <0...
June 22, 2018: American Journal of Cardiology
Raphael Twerenbold, Johannes Tobias Neumann, Nils Arne Sörensen, Francisco Ojeda, Mahir Karakas, Jasper Boeddinghaus, Thomas Nestelberger, Patrick Badertscher, Maria Rubini Giménez, Christian Puelacher, Karin Wildi, Nikola Kozhuharov, Dominik Breitenbuecher, Ewelina Biskup, Jeanne du Fay de Lavallaz, Dayana Flores, Desiree Wussler, Òscar Miró, F Javier Martín Sánchez, Beata Morawiec, Jiri Parenica, Nicolas Geigy, Dagmar I Keller, Tanja Zeller, Tobias Reichlin, Stefan Blankenberg, Dirk Westermann, Christian Mueller
BACKGROUND: The safety of the European Society of Cardiology (ESC) 0/1-h algorithm for rapid rule-out and rule-in of non-ST-segment elevation myocardial infarction (NSTEMI) using high-sensitivity cardiac troponin (hs-cTn) has been questioned. OBJECTIVES: This study aimed to validate the diagnostic performance of the 0/1-h algorithm in a large multicenter study. METHODS: The authors prospectively enrolled unselected patients in 6 countries presenting to the emergency department with symptoms suggestive of NSTEMI...
August 7, 2018: Journal of the American College of Cardiology
Patricia M Fortin, Sally Hopewell, Lise J Estcourt
BACKGROUND: Globally, sickle cell disease (SCD) is one of the commonest severe monogenic disorders, due to the inheritance of two abnormal haemoglobin (beta globin) genes. SCD can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Red blood cell (RBC) transfusions are used to treat complications of SCD, e.g. acute chest syndrome (ACS) (this often involves a single transfusion episode), or they can be part of a regular long-term transfusion programme to prevent SCD complications...
August 1, 2018: Cochrane Database of Systematic Reviews
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