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Cardiac chest pain

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https://www.readbyqxmd.com/read/28454456/pulmonary-artery-intimal-sarcoma-misdiagnosed-as-pulmonary-embolism-a-case-report
#1
Shuyan Jiang, Jiaxin Li, Qingshi Zeng, Jiexian Liang
Intimal sarcoma of the pulmonary artery is rare, but false diagnosis of this sarcoma as pulmonary embolism is not infrequent. The present study reports a case of pulmonary artery intimal sarcoma misdiagnosed as pulmonary artery embolism in a 37-year-old female patient. The patient was admitted to the cardiac intensive care unit of Guangdong General Hospital (Guangzhou, China) with the complaint of progressive exertional dyspnea over the past two years. Multi-slice spiral computed tomography, transthoracic echocardiography, right-heart catheterization and cardiac magnetic resonance imaging revealed mimicking severe pulmonary embolism in the pulmonary trunk and right pulmonary artery, with symptoms including chest pain, cough and breathing difficulties...
April 2017: Oncology Letters
https://www.readbyqxmd.com/read/28447144/-standardized-collection-of-presenting-complaints-in-the-emergency-room-integration-of-coded-presenting-complaints-into-the-electronic-medical-record-system-of-an-emergency-department-and-their-value-for-health-care-research
#2
F Greiner, D Brammen, M Kulla, F Walcher, B Erdmann
BACKGROUND: The point of entry of a patient in emergency care is a symptom or a complaint. To evaluate subsequent processes in an emergency department until a diagnosis is made, this information has to be taken into account. OBJECTIVES: We report the introduction of coded presenting complaints into the electronic medical record system of an emergency department and describe the patients based on these data. METHODS: The CEDIS presenting complaint list was integrated into the emergency department information system of an emergency department (38,000 patients/year)...
April 26, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28446943/the-updated-nice-guidelines-cardiac-ct-as-the-first-line-test-for-coronary-artery-disease
#3
REVIEW
Alastair J Moss, Michelle C Williams, David E Newby, Edward D Nicol
PURPOSE OF REVIEW: Cost-effective care pathways are integral to delivering sustainable healthcare programmes. Due to the overestimation of coronary artery disease using traditional risk tables, non-invasive testing has been utilised to improve risk stratification and initiate appropriate management to reduce the dependence on invasive investigations. In line with recent technological improvements, cardiac CT is a modality that offers a detailed anatomical assessment of coronary artery disease comparable to invasive coronary angiography...
2017: Current Cardiovascular Imaging Reports
https://www.readbyqxmd.com/read/28446942/cardiac-ct-improves-outcomes-in-stable-coronary-heart-disease-results-of-recent-clinical-trials
#4
REVIEW
Michelle C Williams, Alastair Moss, Edward Nicol, David E Newby
PURPOSE OF REVIEW: The purpose of this study was to review the recent randomised controlled trials of coronary computed tomography angiography (CCTA) for patients with stable coronary artery disease. RECENT FINDINGS: The initial results and subsequent papers from the SCOT-HEART (Scottish COmputed Tomography of the HEART) and PROMISE (PROspective Multicentre Imaging Study for Evaluation of chest pain) trials have shown that CCTA is a safe and appropriate addition to standard care or alternative to functional testing...
2017: Current Cardiovascular Imaging Reports
https://www.readbyqxmd.com/read/28443583/retrograde-cerebral-air-embolism-in-a-patient-with-intestinal-necrosis-a-case-report
#5
Onur Taydaş, Mehmet Ruhi Onur, Erhan Akpınar
BACKGROUND: Cerebral venous air embolism (CVAE) is a severe clinical condition related to unfavoured outcome in patients with neurological impairment. CVAE may occur secondary to arterial or venous interventions. A rare mechanism of CVAE is retrograde embolism that is characterized by gas flow in a direction opposite to that of the normal blood flow. CASE REPORT: A 69-year-old female was admitted to our hospital with shortness of breath and abdominal pain. Abdominal computed tomography (CT) revealed intramural gas in the bowel and free gas in the mesenteric veins and portal vein...
April 13, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28441643/ventricular-rupture-following-myocardial-infarction
#6
Christian Fielder Camm, Stefan Neubauer, David P Taggart, Oliver J Rider
A 70-year-old man presented with prolonged cardiac chest pain and was awaiting coronary artery bypass surgery following angiography showing extensive multivessel disease. Following further chest pain, cardiac magnetic resonance imaging showed extensive, contained, ventricular rupture, which was managed aggressively with combined bypass surgery and rupture repair.
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28441614/learning-from-an-analysis-of-closed-malpractice-litigation-involving-myocardial-infarction
#7
Kuan-Han Wu, Yung-Lin Yen, Chien-Hung Wu, Chi-Yuan Hwang, Shih-Yu Cheng
OBJECTIVE: To examine the epidemiologic data, identify the pattern of dispute, and determine clinical litigious errors by analyzing closed malpractice claims involving myocardial infarction (MI) in Taiwanese courts. METHODS: A retrospective descriptive study was performed to analyze the verdicts pertaining to MI from the population-based database of the Taiwan judicial system between 2002 and 2013. The results of adjudication, involved specialists, primary dispute leading to lawsuits, and litigious errors were recorded...
April 13, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28437795/effect-of-using-the-heart-score-in-patients-with-chest-pain-in-the-emergency-department-a-stepped-wedge-cluster-randomized-trial
#8
Judith M Poldervaart, Johannes B Reitsma, Barbra E Backus, Hendrik Koffijberg, Rolf F Veldkamp, Monique E Ten Haaf, Yolande Appelman, Herman F J Mannaerts, Jan-Melle van Dantzig, Madelon van den Heuvel, Mohamed El Farissi, Bernard J W M Rensing, Nicolette M S K J Ernst, Ineke M C Dekker, Frank R den Hartog, Thomas Oosterhof, Ghizelda R Lagerweij, Eugene M Buijs, Maarten W J van Hessen, Marcel A J Landman, Roland R J van Kimmenade, Luc Cozijnsen, Jeroen J J Bucx, Clara E E van Ofwegen-Hanekamp, Maarten-Jan Cramer, A Jacob Six, Pieter A Doevendans, Arno W Hoes
Background: The HEART (History, Electrocardiogram, Age, Risk factors, and initial Troponin) score is an easy-to-apply instrument to stratify patients with chest pain according to their short-term risk for major adverse cardiac events (MACEs), but its effect on daily practice is unknown. Objective: To measure the effect of use of the HEART score on patient outcomes and use of health care resources. Design: Stepped-wedge, cluster randomized trial...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28432166/the-lazarus-phenomenon-spontaneous-cardioversion-after-termination-of-resuscitation-in-a-scottish-hospital
#9
Benjamin Spowage-Delaney, Christopher T Edmunds, Jamie G Cooper
A 66-year-old man suffered a ventricular fibrillation cardiac arrest after an episode of chest pain. Despite advanced life support, his condition deteriorated; the situation was considered irrecoverable and resuscitation was discontinued. The patient was observed for about 5 min with irregular agonal gasping respirations evident but no palpable pulse. A gradual increase in the regularity of breathing pattern heralded the return of spontaneous circulation. An inferior myocardial infarction was diagnosed. Primary percutaneous coronary intervention was performed...
April 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28431769/trends-in-admissions-for-chest-pain-after-the-introduction-of-high-sensitivity-cardiac-troponin-t
#10
Nadia Bandstein, Rickard Ljung, Magnus Lundbäck, Magnus Johansson, Martin J Holzmann
BACKGROUND: The aim was to describe temporal trends in admission rates for chest pain and patient outcomes after the clinical introduction of the high-sensitivity cardiac troponin T (hs-cTnT) assay. METHODS: We included all patients aged >25years presenting with chest pain to the emergency department (ED) at our hospital during 2011-2014. For each year, rates of admissions, coronary angiographies, and revascularizations were determined. After adjustment for confounders, hazard ratios (HR) with 95% confidence intervals (CI) were calculated for mortality or major adverse cardiac events (MACE) within 1year of the ED visit per year, using 2011 as referent...
April 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28429135/clinical-characteristics-of-patients-with-suspected-cardiac-chest-pain-and-angiographically-normal-coronary-arteries-in-a%C3%A2-secondary-care-hospital
#11
T S de Lange, R Y G Tijssen, P Damman, P F M M van Bergen
BACKGROUND: An important number of patients with suspected cardiac chest pain have non-obstructive coronary artery disease. Our purpose was to describe the clinical characteristics of patients with normal or near-normal coronary arteries in routine cardiological practice in a secondary care hospital. METHODS: In 2013, consecutive patients referred for invasive coronary angiography with suspected cardiac chest pain were analysed at a single-centre (Westfriesgasthuis, Hoorn, the Netherlands)...
April 20, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28420670/confirmed-early-myocardial-rupture-in-a-patient-with-pulseless-electrical-activity-pea-following-late-presentation-of-st-elevation-myocardial-infarction
#12
Baskar Sekar, Joe Martins, Sanjiv Petkar
A 69 year old male, an ex-smoker, was admitted with ongoing chest pain of 11 hours duration. Past medical history included treated hypertension and gastro-oesophageal reflux disease. He delayed seeking medical attention as he assumed the pain to be due to indigestion and kept taking antacids without much symptomatic relief. Clinical examination on arrival was unremarkable. Admission 12 lead electrocardiogram (ECG) was diagnostic of a recent anterolateral myocardial infarction (MI) (Figure 1a). Bedside trans-thoracic echocardiogram (TTE) confirmed an established anterolateral MI (Video 1, Figure 1b)...
April 18, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28418572/the-single-high-sensitivity-serum-cardiac-troponin-level-a-significant-advance-for-chest-pain-pathways
#13
William G Kussmaul Iii
No abstract text is available yet for this article.
April 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28418520/rapid-rule-out-of-acute-myocardial-infarction-with-a-single-high-sensitivity-cardiac-troponin-t-measurement-below-the-limit-of-detection-a-collaborative-meta-analysis
#14
John W Pickering, Martin P Than, Louise Cullen, Sally Aldous, Ewoud Ter Avest, Richard Body, Edward W Carlton, Paul Collinson, Anne Marie Dupuy, Ulf Ekelund, Kai M Eggers, Christopher M Florkowski, Yonathan Freund, Peter George, Steve Goodacre, Jaimi H Greenslade, Allan S Jaffe, Sarah J Lord, Arash Mokhtari, Christian Mueller, Andrew Munro, Sebbane Mustapha, William Parsonage, W Frank Peacock, Christopher Pemberton, A Mark Richards, Juan Sanchis, Lukas P Staub, Richard Troughton, Raphael Twerenbold, Karin Wildi, Joanna Young
Background: High-sensitivity assays for cardiac troponin T (hs-cTnT) are sometimes used to rapidly rule out acute myocardial infarction (AMI). Purpose: To estimate the ability of a single hs-cTnT concentration below the limit of detection (<0.005 µg/L) and a nonischemic electrocardiogram (ECG) to rule out AMI in adults presenting to the emergency department (ED) with chest pain. Data Sources: EMBASE and MEDLINE without language restrictions (1 January 2008 to 14 December 2016)...
April 18, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28416358/non-gated-high-pitch-computed-tomography-aortic-angiography-myocardial-perfusion-defects-in-patients-with-suspected-aortic-dissection
#15
Li-Ting Huang, Shih-Hung Chan, Chia-Chang Chuang, Yi-Shan Tsai
OBJECTIVES: To investigate the diagnostic value of first-pass myocardial perfusion defects visualised in non-gated high-pitch computed tomography angiography (CTA) in patients admitted to the emergency department (ED) for suspected aortic dissection. METHODS: We recruited 174 ED patients who underwent high-pitch CTA of the aorta because of suspected aortic dissection. We divided these patients into two groups (diseased and control groups) based on whether their clinical data fulfilled the third universal definition of acute myocardial infarction (AMI), specifically an increase in cardiac troponin (cTn) with at least one of the following: (a) symptoms of ischemia; (b) new ST-segment-T wave (ST-T) changes or new left bundle branch block (LBBB); (c) development of pathological Q wave; (d) new loss of viable myocardium or new regional wall motion abnormality; or (e) identification of an intracoronary thrombus by angiography or autopsy...
April 12, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28416165/influence-of-cardiovascular-risk-in-the-prediction-and-timing-of-cardiac-events-after-exercise-echocardiogram-testing-without-ischemia
#16
Sonia Velasco Del Castillo, Ane Antón Ladislao, Verónica Gómez Sánchez, José Juan Onaindia Gandarias, Ángela Cacicedo Fernández de Bobadilla, Ibon Rodríguez Sánchez, Eva Laraudogoitia Zaldumbide
INTRODUCTION AND OBJECTIVES: There have been no analyses of the influence of cardiovascular risk as a predictor of events in patients with exercise echocardiography (EE) without ischemia. Our objective was to determine the predictors of cardiac events, paying special attention to cardiovascular risk. METHODS: This study included 1640 patients with EE without ischemia. Of these, there were 1206 with no previously known coronary artery disease (CAD), whose risk of a fatal cardiovascular disease event was estimated according to the European SCORE (Systematic COronary Risk Evaluation) risk assessment system, and 434 with known CAD...
April 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28414682/a-left-main-coronary-artery-thrombus-presenting-as-a-non-st-elevation-mi
#17
U Ezema, D Daberkow, T Delord, L Guidry, N R Sells
INTRODUCTION: Left main coronary artery (LMCA); thrombus with an acute myocardial infarction identified with coronary angiography is a clinically rare condition with an extremely high mortality rate. We present a case of LMCA thrombus that presented as a non-ST elevation myocardial infarction (NSTEMI);. CASE: A 45-year-old woman with a history of tobacco use and hyperlipidemia presented with a complaint of 10/10 "hard pain" across her chest radiating to her left shoulder and breast which woke her from sleep...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414673/purulent-pericarditis-due-to-an-infected-pacemaker-lead
#18
Teresa Backes
INTRODUCTION: Intravenous drug users have a substantially increased risk of infective endocarditis, especially in the setting of implanted cardiac devices. Purulent pericarditis is a rare occurrence that can occur iatrogenically or through direct or hematogenous spread. CASE DESCRIPTION: A 75 year old man with a past medical history significant for hepatitis C, IV drug abuse, and sick sinus syndrome status post pacemaker was brought in by EMS with a chief complaint of diaphoresis and chest pain...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414663/not-another-acs-rule-out
#19
S Preston, R Nelson, M Watts, D Smith, T Dewenter, D Spruill
CASE: A 50 year old African-American woman with diabetes, hypertension, and hyperlipidemia presented with progressively worsening retro-sternal chest pain, exacerbated by activity and relieved by rest. She also endorsed a thirty-pound unintentional weight loss, and dysphagia. She was dysarthric with left-sided Bell's Palsy and a palpable left axillary lymph node. She had been evaluated at several hospitals in the previous months for similar typical chest pain. Her troponin values were normal, and an EKG showed T-wave inversions in leads I and aVL...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28413775/an-interesting-case-of-mycoplasma-pneumonia-associated-multisystem-involvement-and-diffuse-alveolar-hemorrhage
#20
Rashmi Mishra, Edison Cano, Sindhaghatta Venkatram, Gilda Diaz-Fuentes
Severe mycoplasma pneumonia is a rare entity with only 0.5-2% of cases having a fulminant course. We present a 74-year-old woman with hypertension, diabetes mellitus and remote history of marginal zone B-cell lymphoma admitted with abdominal pain and diarrhea of 1-2 days associated with body-aches, dyspnea, dry cough and weight loss for 2-3 weeks. On physical exam, she was febrile, tachypneic, tachycardic and hypoxic on room air. Chest examination revealed diffuse crackles and end-expiratory wheezes. Laboratory tests showed anemia, acute-on-chronic kidney injury and hyaline casts and epithelial cells in the urine analysis...
2017: Respiratory Medicine Case Reports
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