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“Acute chest pain”

Martina C de Knegt, Jesper J Linde, Andreas Fuchs, Michael H C Pham, Andreas K Jensen, Børge G Nordestgaard, Henning Kelbæk, Lars V Køber, Merete Heitmann, Gitte Fornitz, Jens D Hove, Klaus F Kofoed
Aims: Quantitative computed tomography (QCT) allows assessment of morphological features of coronary atherosclerosis. We aimed to test the hypothesis that clinical patient presentation is associated with distinct morphological features of coronary atherosclerosis. Methods and results: A total of 1652 participants, representing a spectrum of clinical risk profiles [787 asymptomatic individuals from the general population, 468 patients with acute chest pain without acute coronary syndrome (ACS), and 397 patients with acute chest pain and ACS], underwent multidetector computed tomography...
October 15, 2018: European Heart Journal Cardiovascular Imaging
Volkan Dogan, Oğuzhan Çelik, Bülent Özlek, Eda Özlek, Cem Çil, Özcan Başaran, Murat Biteker
OBJECTIVES: Allergic myocardial infarction, known as Kounis syndrome, is an acute myocardial infarction after an allergic reaction to food, drugs, or insect stings, etc. Kounis syndrome can also be caused by all kinds of seafood, such as finned fish, molluscan shellfish, cephalopods, and crustacean shellfish. METHODS: Herein, we report a case of a 67-year-old man, with hypertension, referred for itchiness, facial rash, chest pain, and palpitations developed after consumption of blue crab...
October 16, 2018: Acta Clinica Belgica
Christiaan Jm Vrints
No abstract text is available yet for this article.
October 2018: European Heart Journal. Acute Cardiovascular Care
Ahmad Hassan, Ronen Jaffe, Ronen Rubinshtein, Basheer Karkabi, David A Halon, Moshe Y Flugelman, Barak Zafrir
BACKGROUND: Contemporary data on clinical profiles and long-term outcomes of young adults with coronary artery disease (CAD) are limited. OBJECTIVES: To determine the risk profile, presentation, and outcomes of young adults undergoing coronary angiography. METHODS: A retrospective analysis (2000-2017) of patients aged ≤ 35 years undergoing angiography for evaluation and/or treatment of CAD was conducted. RESULTS: Coronary angiography was performed in 108 patients (88% males): 67 acute coronary syndrome (ACS) and 41 non-ACS chest pain syndromes...
October 2018: Israel Medical Association Journal: IMAJ
Gianluigi Rellini, Rita Piazza, Elvira Loiudice, Matteo Cassin, Guglielmo Bernardi, Daniela Pavan, Eugenio Cervesato, Gian L Nicolosi
AIM: The aim of this study is to report the heterogeneity of clinical presentation in Tako-Tsubo syndrome (TTS), including a significant prevalence of normal ECG and echocardiographic patterns in a series of consecutive patients from a single center. METHODS AND RESULTS: From our database we selected a total of 168 cases of TTS. A total of 140 of these (Group A); 14 men (10%), mean age 60.3 years, range 39-87; 126 women (90%), mean age 66.1 years, range 43-93; matched the following reported criteria: typical stenocardic pain immediately following an emotional acute stress, or acute medical or surgical event within the preceding 12 h; acute rise and fall of troponin release; absence of significant coronary disease at coronary angiography...
October 12, 2018: Journal of Cardiovascular Medicine
Robert Ohle, Omar Anjum, Helena Bleeker, Sarah McIsaac
INTRODUCTION: Acute aortic syndrome (AAS) is a time sensitive and difficult to diagnose aortic emergency. The American Heart Association (AHA) proposed the acute aortic dissection detection risk score (ADD-RS) as a means to reduce miss rate and improve time to diagnosis. Previous validation studies were performed in a high prevalence population of patients. We do not know how the rule will perform in a lower prevalence population. This is important because application of a rule with low specificity would increase imaging rates and complications...
October 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
T Tarhan, A Meurer, O Tarhan
OBJECTIVE: Description of a novel technique to surgically correct (asymmetric) pectus carinatum and other chest deformities using a metal bar without fixation to the ribs. INDICATIONS: Severe thoracic deformity, extensive psychological strain, social isolation, pain and respiratory complaints. Pseudarthrosis or insufficient correction of a thoracic deformity after prior surgery. Distinctive deformities. CONTRAINDICATIONS: Acute infections...
October 11, 2018: Operative Orthopädie und Traumatologie
Diana Rivero, Mohammad Alhamaydeh, Ziad Faramand, Mohammad Alrawashdeh, Christian Martin-Gill, Clifton Callaway, Barbara Drew, Salah Al-Zaiti
BACKGROUND: Nonspecific ST-T repolarization (NST) abnormalities alter the ST-segment for reasons often unrelated to acute myocardial ischemia, which could contribute to misdiagnosis or inappropriate treatment. We sought to define the prevalence of NST patterns in patients with chest pain and evaluate how such patterns correlate with the eventual etiology of chest pain and course of hospitalization. METHODS: This was a prospective observational study that included consecutive prehospital chest pain patients from three tertiary care hospitals in the U...
October 8, 2018: Heart & Lung: the Journal of Critical Care
M Schmid, C Dodt
Acute and emergency physicians need to make rapid and far-reaching decisions on the basis of little diagnostic information. In patients with symptoms suggestive of a cardiopulmonary diagnosis, point-of-care lung ultrasound (LUS) is becoming increasingly used. In patients with acute dyspnea, chest pain and shock, LUS increases the diagnostic reliability. The BLUE protocol helps to differentiate important diagnoses of acute dyspnea (pulmonary edema, pneumonia, acute respiratory distress syndrome, pulmonary embolism, pleural effusions or pneumothorax)...
October 10, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Claudia Zanetti, Riccardo M Inciardi, Fabio Benedetti, Andrea Rossi
We describe a case of a 21-year-old male, with a history of acute myeloid leukemia (AML) treated with allogeneic hematopoietic cell transplantation, referred to our department for atypical chest pain and dyspnea. Echocardiography revealed an extensive mass involving right cardiac chambers and tricuspid valve annulus, with increased thickness and impairment of right ventricle. Cardiac magnetic resonance confirmed the presence of cardiac mass involving pulmonary artery trunk, pericardial sleeves, and lung parenchyma...
July 2018: Journal of Cardiovascular Echography
Koichiro Nakajima, Hiromitsu Iwata, Hiroyuki Ogino, Yukiko Hattori, Shingo Hashimoto, Toshiyuki Toshito, Kensuke Hayashi, Kenji Akita, Fumiya Baba, Katsumi Nakamae, Jun-Etsu Mizoe, Yuta Shibamoto
BACKGROUND: Two prospective phase II trials were designed to assess the efficacy and safety of image-guided proton therapy (IGPT) for either medically inoperable or operable stage I non-small cell lung cancer (NSCLC). The present study reports the interim results of these trials. METHODS: Fifty-five patients with histologically confirmed stage I NSCLC (IA in 33 patients and IB in 22 patients; inoperable in 21 patients and operable in 34 patients) who received IGPT between July 2013 and February 2017 were analyzed...
October 11, 2018: Radiation Oncology
Per O Andersson, Sofia Sederholm Lawesson, Jan-Erik Karlsson, Staffan Nilsson, Ingela Thylén
BACKGROUND: The characteristics of patients with on-going myocardial infarction (MI) contacting the primary healthcare (PHC) centre before hospitalisation are not well known. Prompt diagnosis is crucial in patients with MI, but many patients delay seeking medical care. The aims of this study was to 1) describe background characteristics, symptoms, actions and delay times in patients contacting the PHC before hospitalisation when falling ill with an acute MI, 2) compare those patients with acute MI patients not contacting the PHC, and 3) explore factors associated with a PHC contact in acute MI patients...
October 10, 2018: BMC Family Practice
Olivia Allen, Ahmed Edhi, Adam Hafeez, Alexandra Halalau
Hepatitis A is a common viral infection with a benign course but in rare cases can progress to acute liver failure. It usually presents with abdominal pain, nausea, vomiting, diarrhea, jaundice, anorexia, or asymptomatically, but it can also present atypically with relapsing hepatitis and prolonged cholestasis. In addition, extrahepatic manifestations have been reported, including urticarial and maculopapular rash, acute kidney injury, autoimmune hemolytic anemia, aplastic anemia, acute pancreatitis, mononeuritis, reactive arthritis, glomerulonephritis, cryoglobulinemia, Guillain-Barre syndrome, and pleural or pericardial effusion...
2018: Case Reports in Medicine
Eleonora Farina, Gabriella Macchia, Milly Buwenge, Giambattista Siepe, Alice Zamagni, Silvia Cammelli, Savino Cilla, Tigeneh Wondemagegnhu, Aynalem A Woldemariam, A F M Kamal Uddin, Mostafà Aziz Sumon, Francesco Cellini, Francesco Deodato, Alessio G Morganti
The main clinical goal for patients with advanced or metastatic thoracic cancer is palliation of tumor-related symptoms and improvement of quality of life. The aim of this phase I-II trial was to define the maximum tolerated dose (MTD) of a short-course of palliative radiotherapy (RT) and to evaluate its efficacy in terms of palliative response. A phase I trial was planned with escalating dose increments. Total doses ranged from 16 to 20 Gy delivered (BID) in two consecutive days. Dose limiting toxicity was defined as any acute grade ≥ 3 toxicity based on the RTOG scale...
October 8, 2018: Clinical & Experimental Metastasis
Adam T Hill, Philip M Gold, Ali El Solh, Joshua P Metlay, Belinda Ireland, Richard S Irwin
BACKGROUND: Patients commonly present to primary care services with upper and lower respiratory tract infections and guidelines to help clinicians investigate and treat acute cough due to suspected pneumonia and influenza are needed. METHODS: A systematic search was carried out with eight PICO questions related to acute cough with suspected pneumonia or influenza. RESULTS: There was a lack of randomized controlled trials in the setting of outpatients presenting with acute cough due to suspected pneumonia or influenza that were not hospitalized...
October 5, 2018: Chest
Dimitrios Papadopoulos, Alexandra Nakou, Konstantinos Lymperopoulos, Vasiliki Filaditaki
A 38-year-old man of Indian origin, who migrated to Greece 13 years prior to presentation, was admitted to our hospital with a 2-month history of nonprogressive, intermittent (mostly evening), low-grade (up to 38.5°C) fever, accompanied by night sweats, dry cough, mild dyspnea on exertion (modified Medical Research Council Dyspnea Scale grade 1), anorexia, fatigue, and weight loss of 10 kg. He also experienced continuous palpitations, which were regular, not associated with chest pain or dizziness, and aggravated on exertion...
October 2018: Chest
Felicity Coad, Catherine Nelson-Piercy
The maternal population in the UK has become an increasingly challenging group of patients to manage. Women with pre-existing and often complex medical conditions are successfully conceiving. Most physicians will have had some involvement in the care of obstetric patients admitted with medical problems, and a lack of experience and fear of causing harm may result in essential investigations and treatment being withheld. The physiological changes in pregnancy can complicate the interpretation of observations and test results...
October 2, 2018: British Journal of Hospital Medicine
Abdulrhman Alghamdi, Laura Howard, Charles Reynard, Philip Moss, Heather Jarman, Kevin Mackway-Jones, Simon Carley, Richard Body
OBJECTIVES: Several decision aids can 'rule in' and 'rule out' acute coronary syndromes (ACS) in the Emergency Department (ED) but all require measurement of blood biomarkers. A decision aid that does not require biomarker measurement could enhance risk stratification at triage and could be used in the prehospital environment. We aimed to derive and validate the History and ECG-only Manchester ACS (HE-MACS) decision aid using only the history, physical examination and ECG. METHODS: We undertook secondary analyses in three prospective diagnostic accuracy studies that included patients presenting to the ED with suspected cardiac chest pain...
October 4, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Juliane Araujo Rodrigues, Karina Melleu, Márcia Moura Schmidt, Carlos Antonio Mascia Gottschall, Maria Antonieta Pereira de Moraes, Alexandre Schaan de Quadros
BACKGROUND: In patients with acute ST-segment elevation myocardial infarction (STEMI), the time elapsed from symptom onset to receiving medical care is one of the main mortality predictors. OBJECTIVE: To identify independent predictors of late presentation in patients STEMI representative of daily clinical practice. METHODS: All patients admitted with a diagnosis of STEMI in a reference center between December 2009 and November 2014 were evaluated and prospectively followed during hospitalization and for 30 days after discharge...
September 21, 2018: Arquivos Brasileiros de Cardiologia
Avneesh Gupta, Jaclyn Furman, Kilak Kesha, Francisco Diaz, Carl J Schmidt
Classic "bread-and-butter" appearance of fibrinous pericarditis had been described in rheumatic disease and other immunologic diseases such as systemic lupus erythematosus, post-myocardial infarct, uremia, tuberculosis, radiation effects, bacterial, and viral etiology. In most of the described cases, pericarditis occurs as a delayed complication. We present a case of a 21-year-old white woman who was seen in the emergency department to rule out pulmonary embolism for shortness of breath, chest pain, and lightheadedness...
October 2, 2018: American Journal of Forensic Medicine and Pathology
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