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Cardiac chest pain

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https://www.readbyqxmd.com/read/28549109/il-18-cleavage-triggers-cardiac-inflammation-and-fibrosis-upon-%C3%AE-adrenergic-insult
#1
Han Xiao, Hao Li, Jing-Jing Wang, Jian-Shu Zhang, Jing Shen, Xiang-Bo An, Cong-Cong Zhang, Ji-Min Wu, Yao Song, Xin-Yu Wang, Hai-Yi Yu, Xiang-Ning Deng, Zi-Jian Li, Ming Xu, Zhi-Zhen Lu, Jie Du, Wei Gao, Ai-Hua Zhang, Yue Feng, You-Yi Zhang
Aims: Rapid over-activation of β-adrenergic receptor (β-AR) upon stress leads to cardiac inflammation, a prevailing factor that underlies heart injury. However, mechanisms by which acute β-AR stimulation induce cardiac inflammation still remain unknown. Here, we set out to identify the crucial role of inflammasome/interleukin (IL)-18 in initiating and maintaining cardiac inflammatory cascades upon β-AR insult. Methods and results: Male C57BL/6 mice were injected with a single dose of β-AR agonist, isoproterenol (ISO, 5 mg/kg body weight) or saline subcutaneously...
May 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28545635/outcomes-in-patients-with-chest-pain-discharged-after%C3%A2-evaluation-using-a-high-sensitivity-troponin-t-assay
#2
Atosa Nejatian, Åsa Omstedt, Jonas Höijer, L O Hansson, Therese Djärv, Kai M Eggers, Per Svensson
BACKGROUND: Most patients with chest pain are discharged from the emergency department (ED) with the diagnosis "unspecified chest pain." It is unknown if evaluation with a high-sensitivity troponin T (hsTnT) assay affects prognosis in this large population. OBJECTIVES: The aim was to investigate whether the introduction of an hsTnT assay is associated with reduced incidence of major adverse cardiac events (MACEs) and cardiovascular (CV) risk profile in patients with chest pain discharged from the ED...
May 30, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28544100/undetectable-concentrations-of-an-fda-approved-high-sensitivity-cardiac-troponin-t-assay-to-rule-out-acute-myocardial-infarction-at-emergency-department-arrival
#3
Andrew D McRae, Grant Innes, Michelle Graham, Eddy Lang, James E Andruchow, Yunqi Ji, Shabnam Vatanpour, Tasnima Abedin, Hong Yang, Danielle A Southern, Dongmei Wang, Isolde Seiden-Long, Lawrence DeKoning, Peter Kavsak
BACKGROUND: The objective of this study was to quantify the sensitivity of very low concentrations of high-sensitivity cardiac troponin T (hsTnT) at ED arrival for acute myocardial infarction (AMI) in a large cohort of chest pain patients evaluated in real-world clinical practice. METHODS: This retrospective study included consecutive ED patients with suspected cardiac chest pain evaluated in four urban EDs were, excluding those with ST-elevation AMI, cardiac arrest or abnormal kidney function...
May 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28540208/myocardial-ct-perfusion-imaging-for-ischemia-detection
#4
REVIEW
Patricia Carrascosa, Carlos Capunay
Coronary computed tomography angiography (CCTA) plays an important role in many specific scenarios such as in symptomatic patients with intermediate pretest of coronary artery disease (CAD), as well as in the triage of patients with acute chest pain with TIMI risk ≤2. However, it cannot detect the presence of associated ischemia, which is critical for clinical decision making among patients with moderate to severe stenosis. Although functional information can be obtained with different non-invasive tools, cardiac CT is the unique modality that can perform a comprehensive evaluation of coronary anatomy plus the functional significance of lesions...
April 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28536223/cardiac-compression-due-to-gastric-volvulus-an-unusual-cause-of-chest-pain
#5
Alex Brown, David Austin, Venkatesh Kanakala
A 42-year-old man was admitted to coronary care for assessment with severe retrosternal chest pain. Echocardiography showed significant external compression of the left atrium. A subsequent CT scan revealed him to have a large hiatus hernia, with most of his stomach herniating into his thorax causing left atrial compression and gastric volvulus. He subsequently underwent successful emergency decompression of the gastric volvulus and repair of his hiatus hernia.
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28534694/the-heart-score-for-early-rule-out-of-acute-coronary-syndromes-in-the-emergency-department-a-systematic-review-and-meta-analysis
#6
Patricia Van Den Berg, Richard Body
AIMS: The objective of this systematic review was to summarise the current evidence on the diagnostic accuracy of the HEART score for predicting major adverse cardiac events in patients presenting with undifferentiated chest pain to the emergency department. METHODS AND RESULTS: Two investigators independently searched Medline, Embase and Cochrane databases between 2008 and May 2016 identifying eligible studies providing diagnostic accuracy data on the HEART score for predicting major adverse cardiac events as the primary outcome...
May 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28533990/anomalous-origin-of-right-coronary-artery-originating-from-the-pulmonary-trunk-arcapa-an-incidental-finding-in-a-patient-presenting-with-chest-pain
#7
Pragathi Balakrishna, Michael Illovsky, Youssef M Al-Saghir, Abdul M Minhas
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly with an estimated prevalence of 0.002%. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest. We present a case of a 55-year-old female with a history of hypertension who presented to the emergency department with intermittent chest discomfort for three days...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28532506/clinical-evaluation-of-myocardial-involvement-in-acute-myopericarditis-in-young-adults
#8
Ersin Saricam, Yasemin Saglam, Tuncay Hazirolan
BACKGROUND: Myocardial involvement in young adults has various causes. Acute myopericarditis is one of the myocardial involvements in young adults. It is easy to confuse with acute ST-elevation myocardial infarction because of the electrocardiographic features. This study aims to investigate a number of imaging techniques and clinical features for acute myopericarditis in young adults (<30 years of age). METHODS: This retrospective study included 147 patients selected from the 2147 patients at the age of <30 with acute chest pain admitted into emergency service between 2010 and 2016...
May 22, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28521195/diabetes-and-impaired-glucose-metabolism-is-associated-with-more-cold-related-cardiorespiratory-symptoms
#9
Tiina Maria Ikäheimo, Jari Jokelainen, Juhani Hassi, Liisa Hiltunen, Sirkka Keinänen-Kiukaanniemi, Tiina Laatikainen, Pekka Jousilahti, Markku Peltonen, Leena Moilanen, Juha Saltevo, Simo Näyhä
AIMS: Diabetes and impaired glucose metabolism cause metabolic, neural and circulatory disturbances that may predispose to adverse cooling and related symptoms during the cold season. This study assessed the prevalence of cold-related cardiorespiratory symptoms in the general population according to glycaemic status. METHODS: The study population consisted of 2436 men and 2708 women aged 45-74years who participated in the National FINRISK cold sub-studies in 2002 and 2007...
May 4, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28518009/aeromedical-evacuation-using-extra-corporeal-life-support-after-resuscitated-cardiac-arrest
#10
David Gerard, Hervé Raffin, Guillaume Lebreton
BACKGROUND: Extra corporeal life support (ECLS) is presently first line therapy for refractory cardiogenic shock. Mobile circulatory support teams implant ECLS or extra corporeal membrane oxygenation (ECMO) in patients in the hospital without circulatory support. These patients are then transported to specialized centers. Here we report a case of sending a mobile circulatory support team abroad, followed by air ambulance evacuation, which, to our knowledge, has never been used as part of medical assistance abroad...
April 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28515825/late-presentation-of-aortic-aneurysm-and-dissection-following-cardiac-catheterization
#11
Abimbola Shofu, G Mustafa Awan, Bassam Omar, Ghazanfar Qureshi
We report a 63-year-old female with hypertension, hyperlipidemia, and prior pacemaker insertion for atrial fibrillation with symptomatic bradycardia, who was admitted with substernal chest pressure and diaphoresis. Her electrocardiogram revealed atrial fibrillation with demand ventricular pacing and her cardiac biomarkers were negative for acute coronary syndrome. Echocardiogram revealed normal left ventricular systolic function and normal aortic root diameter. Coronary angiography revealed 60-70% obtuse marginal lesion, otherwise mild disease...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515749/thromboembolic-complications-after-an-ankle-joint-open-fracture-in-a-patient-with-a-history-of-deep-vein-thrombosis-in-the-lower-limbs
#12
Tomasz Stankowski, Sleiman Sebastian Aboul-Hassan, Piotr Stępiński, Anna Szymańska, Jakub Marczak, Romuald Cichoń
A 55-year-old patient was admitted to the Department of Orthopedics due to an open fracture in the right ankle joint. On the seventh day of hospitalization the patient experienced a transient ischemic attack. During the next day, dyspnea, chest pain and a 'rider' type pulmonary embolism in the pulmonary trunk occluding both pulmonary arteries and its branches were diagnosed. The patient was transferred to the Department of Cardiac Surgery. He underwent pulmonary embolectomy for massive pulmonary, right and left atrial embolism, and left ventricular embolism...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28515106/direct-comparison-of-2-rule-out-strategies-for-acute-myocardial-infarction-2-h-accelerated-diagnostic-protocol-vs-2-h-algorithm
#13
Karin Wildi, Louise Cullen, Raphael Twerenbold, Jaimi H Greenslade, William Parsonage, Jasper Boeddinghaus, Thomas Nestelberger, Zaid Sabti, Maria Rubini-Giménez, Christian Puelacher, Janosch Cupa, Lukas Schumacher, Patrick Badertscher, Karin Grimm, Nikola Kozhuharov, Claudia Stelzig, Michael Freese, Katharina Rentsch, Jens Lohrmann, Wanda Kloos, Andreas Buser, Tobias Reichlin, John Pickering, Martin Than, Christian Mueller
BACKGROUND: We compared 2 high-sensitivity cardiac troponin (hs-cTn)-based 2-h strategies in patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED): the 2-h accelerated diagnostic protocol (2h-ADP) combining hs-cTn, electrocardiogram, and a risk score, and the 2-h algorithm exclusively based on hs-cTn concentrations and their absolute changes. METHODS: Analyses were performed in 2 independent diagnostic cohorts [European Advantageous Predictors of Acute Coronary Syndrome Evaluation (APACE) study, Australian-New Zealand 2-h Accelerated Diagnostic Protocol to Assess patients with chest Pain symptoms using contemporary Troponins as the only biomarker (ADAPT) study] employing hs-cTnT (Elecsys) and hs-cTnI (Architect)...
May 17, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28511924/evaluation-of-the-effectiveness-of-a-phone-based-care-coordination-pilot-on-hospital-utilisation-and-costs-for-patients-with-chest-pain
#14
Peita Price, Ruth Vincent, Mark Tacey, Jane Gilchrist, Danny Liew, Leeanne Grigg, Lucio Naccarella
BACKGROUND: A small percentage of the population represents a disproportionate number of attendances at emergency departments (ED). "Frequent presenters" to ED with chest pain do not always fit into established pathways for acute myocardial events. With accelerated "rule out" protocols, patients are often discharged from the Emergency Department (ED) after short lengths of stay. This research will evaluate the effectiveness of a phone based care-coordination pilot designed to meet the needs of patients attending ED with cardiac and non-cardiac chest pain...
April 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28509783/the-evaluation-of-adolescent-chest-pain-a-screening-ecg-or-psc-17
#15
Patricia E Acra, María T Pérez
PURPOSE OF REVIEW: The present review offers an update on entities presenting as chest pain in the adolescent population. It discusses recently proposed tools and shared mental models used in primary and urgent care settings to evaluate chest pain, and their focus on identifying life-threatening processes. We consider whether the current practice may be improved by accounting for the increasingly recognized non-life-threatening causes of adolescent chest pain. RECENT FINDINGS: The present experiences and behaviors of adolescents have added new causes of chest pain to the work-up of this disquieting chief complaint...
May 13, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28501373/evaluating-appropriate-use-of-pediatric-echocardiograms-for-chest-pain-in-outpatient-clinics
#16
Reid C Chamberlain, Jonathan H Pelletier, Sarah Blanchard, Christoph P Hornik, Kevin D Hill, Michael J Campbell
BACKGROUND: Echocardiography is often used in the evaluation of pediatric chest pain, but the incidence of cardiac pathology is low. In 2014, the American College of Cardiology published appropriate use criteria (AUC) for echocardiography including recommendations for pediatric chest pain. We evaluated the frequency and diagnostic yield of echocardiograms performed for each AUC indication and cost associated with echocardiograms performed for indications meeting the "rarely appropriate" criteria...
May 10, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28500753/a-0h-1h-protocol-for-safe-early-discharge-of-chest-pain-patients
#17
Arash Mokhtari, Bertil Lindahl, Alexandru Schiopu, Troels Yndigegn, Ardavan Khoshnood, Patrik Gilje, Ulf Ekelund
OBJECTIVES: Guidelines recommend a 0h/1h high-sensitivity cardiac troponin T (hs-cTnT) diagnostic strategy in acute chest pain patients. There is however little data on the performance of this strategy when combined with clinical risk stratification. We aimed to evaluate the diagnostic accuracy of an accelerated diagnostic protocol (ADP) using the 0h/1h hs-cTnT strategy together with an adapted Thrombolysis In Myocardial Infarction (TIMI) score and ECG for ruling out major adverse cardiac events (MACE) within 30 days...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28500087/feasibility-of-the-manchester-acute-coronary-syndromes-macs-decision-rule-to-safely-reduce-unnecessary-hospital-admissions-a-pilot-randomised-controlled-trial
#18
Richard Body, Charles Boachie, Alex McConnachie, Simon Carley, Patricia Van Den Berg, Fiona E Lecky
BACKGROUND: Observational studies suggest that the Manchester Acute Coronary Syndromes (MACS) decision rule can effectively 'rule out' and 'rule in' acute coronary syndromes (ACS) following a single blood test. In a pilot randomised controlled trial, we aimed to determine whether a large trial is feasible. METHODS: Patients presenting to two EDs with suspected cardiac chest pain were randomised to receive care guided by the MACS decision rule (intervention group) or standard care (controls)...
May 12, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28497558/ectopic-thyroid-mass-in-the-right-ventricle-a-case-report
#19
Yuying Tan, Wei Yu, Xiaocong Wang, Yongsheng Gao, Hui Xu
Ectopic thyroid is a rare congenital embryonic anomaly. Ectopic thyroid tissue can be located anywhere during its descent, but it is found primarily at the base of the tongue and in the mediastinum. It is very rarely found in the heart. Here, we report a rare case of cardiac ectopic thyroid tissue in a 53-year-old woman who presented with chest pain. Echocardiography revealed an intracardiac mass that was removed successfully. Histopathology confirmed that the mass was thyroid tissue without malignancy.
May 12, 2017: Echocardiography
https://www.readbyqxmd.com/read/28497506/left-ventricular-obstruction-caused-by-a-large-hiatal-hernia
#20
Kenji Harada, Ushio Tamura, Chiyo Ichimiya, Naho Terada, Yasuhiro Yokoyama, Norihito Kageyama, Akira Hirono, Yuya Hiroshima, Takeshi Omura, Hirofumi Yamamoto, Hiroyuki Fujinaga
A 76-year-old man was admitted to our emergency department owing to chest pain, which started immediately after lunch. Although electrocardiogram revealed ST-segment elevation with hyperacute T-wave changes in the anterior lead tracings, emergency coronary angiography revealed normal coronary arteries. Echocardiography revealed left ventricular (LV) compression with left ventricular obstruction (LVO) caused by an echogenic mass. Computed tomography clearly revealed compression of both left atrial (LA) and LV by a large hiatal hernia...
May 12, 2017: Echocardiography
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