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Cardiac chest pain

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https://www.readbyqxmd.com/read/28087181/challenging-the-99th-percentile-a-lower-troponin-cutoff-leads-to-low-mortality-of-chest-pain-patients
#1
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/28081310/a-simple-risk-score-in-acute-st-elevation-myocardial-infarction-modified-acef-age-creatinine-and-ejection-fraction-score
#2
Arzu Kalaycı, Vecih Oduncu, Çetin Geçmen, Selim Topcu, Can Yücel Karabay, İbrahim Akın İzgi, Cevat Kırma
BACKGROUND/AIM: The aim of this study was to evaluate if the modified ACEF (age, creatinine, and ejection fraction) score is a predictor of major adverse cardiac and cerebrovascular events during 1 year of follow-up in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). MATERIALS AND METHODS: We retrospectively enrolled 1632 consecutive patients who were admitted to our emergency department diagnosed with STEMI within 12 h of chest pain and treated with primary PCI...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28077467/gut-microbiota-dependent-trimethylamine-n-oxide-in-acute-coronary-syndromes-a-prognostic-marker-for-incident-cardiovascular-events-beyond-traditional-risk-factors
#3
Xinmin S Li, Slayman Obeid, Roland Klingenberg, Baris Gencer, François Mach, Lorenz Räber, Stephan Windecker, Nicolas Rodondi, David Nanchen, Olivier Muller, Melroy X Miranda, Christian M Matter, Yuping Wu, Lin Li, Zeneng Wang, Hassan S Alamri, Valentin Gogonea, Yoon-Mi Chung, W H Wilson Tang, Stanley L Hazen, Thomas F Lüscher
AIMS: Systemic levels of trimethylamine N-oxide (TMAO), a pro-atherogenic and pro-thrombotic metabolite produced from gut microbiota metabolism of dietary trimethylamine (TMA)-containing nutrients such as choline or carnitine, predict incident cardiovascular event risks in stable primary and secondary prevention subjects. However, the prognostic value of TMAO in the setting of acute coronary syndromes (ACS) remains unknown. METHODS AND RESULTS: We investigated the relationship of TMAO levels with incident cardiovascular risks among sequential patients presenting with ACS in two independent cohorts...
January 11, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28063854/hospital-admissions-for-chest-pain-associated-with-cocaine-use-in-the-united-states
#4
Vikas Singh, Alex P Rodriguez, Badal Thakkar, Ghamshyambhai R Savani, Nileshkumar J Patel, Apurva O Badheka, Mauricio G Cohen, Carlos E Alfonso, Raul D Mitrani, Juan Viles-Gonzalez, Jeffrey J Goldberger
BACKGROUND: The outcomes related to chest pain associated with cocaine use and its burden on healthcare system are not well studied. METHODS: Data were collected from the Nationwide Inpatient Sample (2001 - 2012). Subjects were identified by using the ICD-9-CM codes. Primary outcome was a composite of mortality, myocardial infarction, stroke and cardiac arrest. RESULTS: We identified 363,143 admissions for cocaine induced chest pain. Mean age was 44...
January 4, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28057790/novel-risk-markers-and-risk-assessments-for-cardiovascular-disease
#5
REVIEW
Mark R Thomas, Gregory Y H Lip
The use of risk markers has transformed cardiovascular medicine, exemplified by the routine assessment of troponin, for both diagnosis and assessment of prognosis in patients with chest pain. Clinical risk factors form the basis for risk assessment of cardiovascular disease and the addition of biochemical, cellular, and imaging parameters offers further refinement. Identifying novel risk factors may allow greater risk stratification and a steady, but gradual progression toward precision medicine. Indeed, the generation of data in this area of research is explosive and when combined with new technologies and techniques provides the potential for more refined, targeted approaches to cardiovascular medicine...
January 6, 2017: Circulation Research
https://www.readbyqxmd.com/read/28056838/first-case-report-of-myopericarditis-linked-to-campylobacter-coli-enterocolitis
#6
Cameron R M Moffatt, Soniah B Moloi, Karina J Kennedy
BACKGROUND: Campylobacter spp. are a common cause of mostly self-limiting enterocolitis. Although rare, pericarditis and myopericarditis have been increasingly documented as complications following campylobacteriosis. Such cases have occurred predominantly in younger males, and involved a single causative species, namely Campylobacter jejuni. We report the first case of myopericarditis following Campylobacter coli enterocolitis, with illness occurring in an immunocompetent middle-aged female...
January 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28054396/incremental-value-of-contrast-echocardiography-in-the-evaluation-of-a-cardiac-thrombus
#7
Jose Ricardo F Po, Matthew S Tong, Erica L Grove, Robert W W Biederman
A 52-year-old man presented with altered mental status and report of prior complaint of chest pain. On electrocardiography, anterolateral ST-segment elevations with Q-waves in the septal leads were seen. Initial echocardiography images demonstrated a thickened anteroseptum. Further imaging showed the presence of a well-attached laminated apical thrombus. Contrast echocardiography images showed that the thrombus had minimal attachment to the endocardial surface. CT head subsequently showed the presence of acute stroke...
January 5, 2017: Echocardiography
https://www.readbyqxmd.com/read/28051221/contribution-of-cardiac-magnetic-resonance-imaging-in-the-diagnosis-of-acute-coronary-syndrome-with-normal-coronary-angiography
#8
Rana Dahmani, Rim Ben Said, Younes Arous, Houaida Mahfoudhi, Chedia Chourabi, Mehdi Ghommidh, Badii Jedaida, Nizar Ben Mansour, Abdeddayem Haggui, Nadhem Hajlaoui, Dhaker Lahidheb, Wafa Fehri, Habib Haouala
Background - Acute coronary syndrome with high level of troponin is a common pattern for emergency consultation. In 10% of cases, coronary angiography concluded that there were no significant coronary lesions. The contribution of cardiac magnetic resonance imaging (MRI) in the etiological investigation is increasing in these conditions. Aim - We analyzed the diagnostic value of cardiac MRI in case of acute coronary syndromes with elevated troponin and normal coronary angiography. Methods - It's a retrospective analytical study including 31 patients presenting with acute coronary syndrome with positive troponins and normal coronary angiography...
June 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28042398/quality-of-life-in-patients-with-coronary-artery-disease-and-panic-disorder-a-comparative-study
#9
Shruti Srivastava, Skand Shekhar, Manjeet Singh Bhatia, Shridhar Dwivedi
OBJECTIVES: The quality of life (QOL) of patients with coronary artery disease (CAD) is known to be impaired. Non-cardiac chest pain referrals are often under-diagnosed and untreated, and there are hardly any studies comparing the QOL of CAD and panic disorder related (non-cardiac) chest pain referrals (PDRC). METHODS: We assessed the psychiatric morbidity and QOL of patients newly diagnosed with CAD (n = 40) at baseline and six weeks post-treatment and compared their QOL with patients with PDRC (n = 40) and age- and gender-matched healthy controls (n = 57)...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28041701/depression-and-chest-pain-in-patients-with-coronary-artery-disease
#10
Salim S Hayek, Yi-An Ko, Mosaab Awad, Andrea Del Mar Soto, Hina Ahmed, Keyur Patel, Michael Yuan, Spencer Maddox, Brandon Gray, Jamal Hajjari, Laurence Sperling, Amit Shah, Viola Vaccarino, Arshed A Quyyumi
BACKGROUND: Depression is common in patients with coronary artery disease (CAD) and is associated with more frequent chest pain. It is however unclear whether this is due to differences in underlying CAD severity. We sought to determine [1] whether depressive symptoms are associated with chest pain independently of CAD severity, [2] whether improvement in depressive symptoms over time is associated with improvement in chest pain and [3] whether the impact of revascularization on chest pain differs between patients with and without depression...
December 23, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28039663/whooping-cough-in-adults-a-series-of-severe-cases
#11
Katarzyna Zycinska, M Cieplak, M Chmielewska, A Nitsch-Osuch, A Klaczkow, M Hadzik-Blaszczyk, Z Kur, K A Wardyn
Bordetella pertussis is a gram-negative aerobic coccobacillus causing contagious respiratory tract disease called whooping cough. The virulence factors consist of pertussis toxin, filamentous hemagglutinin, fimbriae, lipooligosaccharide, and adenylate cyclase toxin. The disease causes a worldwide threat to public health despite a high vaccination coverage. The course of whooping cough in adults is frequently atypical, causing difficulty in diagnosis. In this report we present five patients hospitalized with Bordetella pertussis infection manifesting atypical and severe symptoms...
December 31, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28033243/prognostic-values-of-4-risk-scores-in-chinese-patients-with-chest-pain-prospective-2-centre-cohort-study
#12
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/28031691/cardiac-tamponade-after-right-ventricular-perforation-caused-by-screw-in-lead
#13
Lovel Giunio, Teo Boric, Cristijan Bulat, Dragan Dragicevic, Mislav Lozo
A 69-year-old man was admitted after syncope followed with chest pain and signs of cardiac tamponade. He had undergone permanent dual-chamber pacemaker implantation 3 weeks earlier. Transthoracic echocardiography (TTE) confirmed a pericardial effusion, and urgent pericardial drainage was performed. Right ventricular perforation caused by active-fixation (screw-in) lead was verified by multislice computed tomography. The lead was extracted under fluoroscopy and bedside TTE monitoring in the operating room with cardiothoracic surgery backup...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28031652/anomalous-the-left-main-coronary-artery-originating-from-the-right-coronary-artery
#14
Kanber Ocal Karabay, Bayram Bagirtan, Gurkan Geceer, Abdulmelik Yildiz, Gokhan Bektasoglu
The coronary anomalies are rarely seen in clinical practice. A 47-year-old female patient presented to hospital with chest pain on exertion. The coronary angiography and cardiac tomography showed the anomalous origin of the left main from the right coronary artery.
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28031149/diagnostic-and-prognostic-value-of-a-careful-symptom-evaluation-and-high-sensitive-troponin-in-patients-with-suspected-stable-angina-pectoris-without-prior-cardiovascular-disease
#15
Debbie M Madsen, Axel C P Diederichsen, Susanne E Hosbond, Oke Gerke, Hans Mickley
BACKGROUND AND AIMS: Typical angina pectoris (AP) and high-sensitive troponin I (hs-TnI) are independently associated with coronary artery disease (CAD) and future cardiovascular events (CVE). This study aimed to assess the individual and combined diagnostic and prognostic impact of symptoms and hs-TnI in stable chest pain patients without prior cardiovascular disease. METHODS: During a one-year period, 487 patients with suspected stable AP underwent invasive or CT-coronary angiography (significant stenosis ≥50%)...
November 28, 2016: Atherosclerosis
https://www.readbyqxmd.com/read/28029000/comparison-between-soluble-st2-and-high-sensitivity-troponin-i-in-predicting-short-term-mortality-for-patients-presenting-to-the-emergency-department-with-chest-pain
#16
Rossella Marino, Laura Magrini, Francesca Orsini, Veronica Russo, Patrizia Cardelli, Gerardo Salerno, Mina Hur, Salvatore Di Somma
BACKGROUND: High-sensitivity cardiac troponin I (hs-cTnI) and the soluble isoform of suppression of tumorigenicity 2 (sST2) are useful prognostic biomarkers in acute coronary syndrome (ACS). The aim of this study was to test the short term prognostic value of sST2 compared with hs-cTnI in patients with chest pain. METHODS: Assays for hs-cTnI and sST2 were performed in 157 patients admitted to the Emergency Department (ED) for chest pain at arrival. In-hospital and 30-day follow-up mortalities were assessed...
March 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28028503/cardiac-hydatid-cyst-a-case-report
#17
Esfandiar Shojaei, Zeynab Yassin, Omid Rezahosseini
Hydatid disease commonly involves liver but in rare cases, it can involve cardiac structures. A 75-yr-old farmer from Parsabad-Moghan, northwestern Iran was presented to the Emergency Room of Tehran Imam Khomeini Hospital, Tehran, Iran with dyspnea and without chest pain in 2014. A lesion compatible with hydatid cyst was found in echocardiography and confirmed by serology and MRI. Surgical treatment was done but the patient was died in recovery room because of cardiac arrhythmia. In endemic areas, hydatid cyst should be considered in differential diagnosis of heterogeneous echogenic lesions even if the serologic tests are negative...
November 2016: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/28027841/kawasaki-disease-with-coronary-artery-aneurysms-psychosocial-impact-on-parents-and-children
#18
Nita Chahal, Ahlexxi Jelen, Janet Rush, Cedric Manlhiot, Katherine M Boydell, Renee Sananes, Brian W McCrindle
INTRODUCTION: For those living with Kawasaki disease and coronary artery aneurysms, little is known about the psychosocial burden faced by parents and their children. METHODS: Exploratory, descriptive, mixed-methods design examining survey and interview data about health-related uncertainty, intrusiveness, and self-efficacy. RESULTS: Parents' uncertainty was associated with missed diagnosis, higher income, and maternal education. Higher uncertainty scores among children were associated with absence of chest pain and lower number of echocardiograms...
December 24, 2016: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28027742/prognostic-value-of-ct-derived-left-atrial-and-left-ventricular-measures-in-patients-with-acute-chest-pain
#19
Richard A P Takx, Rozemarijn Vliegenthart, U Joseph Schoepf, John W Nance, Fabian Bamberg, Joseph A Abro, Christine M Carr, Sheldon E Litwin, Paul Apfaltrer
PURPOSE: To determine which left atrial (LA) and left ventricular (LV) parameters are associated with future major adverse cardiac event (MACE) and whether these measurements have independent prognostic value beyond risk factors and computed tomography (CT)-derived coronary artery disease measures. MATERIALS AND METHODS: This retrospective analysis was performed under an IRB waiver and in HIPAA compliance. Subjects underwent coronary CT angiography (CCTA) using a dual-source CT system for acute chest pain evaluation...
January 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28024553/sustained-performance-of-a-physicianless-system-of-automated-prehospital-stemi-diagnosis-and-catheterization-laboratory-activation
#20
Brian J Potter, Alexis Matteau, Samer Mansour, Charbel Naim, Mounir Riahi, Richard Essiambre, Martine Montigny, Isabelle Sareault, François Gobeil
BACKGROUND: Treatment times for primary percutaneous coronary intervention frequently exceed the recommended maximum delay. Automated "physicianless" systems of prehospital cardiac catheterization laboratory (CCL) activation show promise, but have been met with resistance over concerns regarding the potential for false positive and inappropriate activations (IAs). METHODS: From 2010 to 2015, first responders performed electrocardiograms (ECGs) in the field for all patients with a complaint of chest pain or dyspnea...
January 2017: Canadian Journal of Cardiology
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