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Cardiac chest pain symptoms

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https://www.readbyqxmd.com/read/28416358/non-gated-high-pitch-computed-tomography-aortic-angiography-myocardial-perfusion-defects-in-patients-with-suspected-aortic-dissection
#1
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/28414663/not-another-acs-rule-out
#2
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/28379388/prevalence-of-obstructive-coronary-artery-disease-and-prognosis-in-patients-with-stable-symptoms-and-a-zero-coronary-calcium-score
#3
Tarun K Mittal, Alison Pottle, Ed Nicol, Mahmoud Barbir, Ben Ariff, Saeed Mirsadraee, Michael Dubowitz, Diana A Gorog, Piers Clifford, Soroosh Firoozan, Robert Smith, Simon Dubrey, Harmeet Chana, Jaymin Shah, Nigel Stephens, Christopher Travill, Andrew Kelion, Mini Pakkal, Adam Timmis
Aims: CT calcium scoring (CTCS) and CT cardiac angiography (CTCA) are widely used in patients with stable chest pain to exclude significant coronary artery disease (CAD). We aimed to resolve uncertainty about the prevalence of obstructive coronary artery disease and long-term outcomes in patients with a zero-calcium score (ZCS). Methods and results: Consecutive patients with stable cardiac symptoms referred for CTCS or CTCS and CTCA from chest pain clinics to a tertiary cardiothoracic centre were prospectively enrolled...
March 31, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28377021/triggers-and-timing-of-acute-coronary-syndromes
#4
Geoffrey H Tofler, Eran Kopel, Robert Klempfner, Michael Eldar, Thomas Buckley, Ilan Goldenberg
Previous studies have shown that an acute coronary syndrome (ACS) may be triggered by external activities; however, their frequency, predictors, and significance are uncertain. We evaluated data from the National Israel Survey of Acute Coronary Syndromes, which was conducted in 2004 (February to March) in all 25 coronary care units and cardiac wards in Israel. Demographic and clinical data were recorded for consecutive participants, including potential triggers and time of symptom onset of ACS. Among the 1,849 patients who completed the trigger question, 1/4 (25...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28365634/lesson-of-the-month-1-beware-the-atypical-presentation-eosinophilic-granulomatosis-with-polyangiitis-presenting-as-acute-coronary-syndrome
#5
Juergen Schiefermueller, Bashir Alaour, Alison Calver, Nick Curzen
We describe the case of a 45-year-old woman presenting with troponin positive cardiac-sounding chest pain. An initial emergency angiogram demonstrated two vessel coronary disease, including a distal right coronary artery occlusion. No percutaneous coronary intervention was performed and the patient was treated medically. At re-presentation with further pain a few days later, coronary angiography demonstrated no significant coronary lesions. After consideration of other multisystem symptoms and raised eosinophil count, the patient was diagnosed with eosinophilic granulomatosis with polyangiitis (formerly known as Churg-Strauss syndrome) presenting with coronary arteritis...
April 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28363994/validating-the-manchester-acute-coronary-syndromes-macs-and-troponin-only-manchester-acute-coronary-syndromes-t-macs-rules-for-the-prediction-of-acute-myocardial-infarction-in-patients-presenting-to-the-emergency-department-with-chest-pain
#6
Jaimi H Greenslade, Robert Nayer, William Parsonage, Shaela Doig, Joanna Young, John W Pickering, Martin Than, Christopher Hammett, Louise Cullen
BACKGROUND: The Manchester Acute Coronary Syndromes (MACS) rule and the Troponin-only MACS (T-MACS) rule risk stratify patients with suspected acute coronary syndrome (ACS). This observational study sought to validate and compare the MACS and T-MACS rules for assessment of acute myocardial infarction (AMI). METHODS: Prospectively collected data from twoEDs in Australia and New Zealand were analysed. Patients were assigned a probability of ACS based on the MACS and T-MACS rules, incorporating high-sensitivity troponin T, heart-type fatty acid-binding protein, ECG results and clinical symptoms...
March 31, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28350720/pulmonary-embolism-mimicking-infectious-pleuritis
#7
Kenichi Tetsuhara, Satoshi Tsuji, Satoko Uematsu, Koichi Kamei
The diagnosis of pulmonary thromboembolism (PE) is often delayed because it is usually misdiagnosed as pneumonia or deep vein thrombosis. We report an unusual case of PE misdiagnosed as viral pleuritis on the first arrival at the emergency department (ED) in our hospital. A 14-year-old girl with no previous significant medical history was referred to the ED with pleuritic and chest pain with low-grade fever 4 days before admission.Echography showed a small amount of left pleural effusion. A 12-lead electrocardiogram was normal...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28349017/psychological-symptoms-predicted-chest-pain-intensity-and-discomfort-in-cardiac-rehabilitation-patients
#8
Saeid Komasi, Ali Soroush, Mozhgan Saeidi
No abstract text is available yet for this article.
October 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28347554/long-term-mortality-of-emergency-medical-services-patients
#9
Morten T Bøtker, Christian J Terkelsen, Jan N Sørensen, Søren B Jepsen, Søren P Johnsen, Erika F Christensen, Mikkel S Andersen
STUDY OBJECTIVE: Emergency medical services (EMS) provides out-of-hospital care to patients with life-threatening conditions, but the long-term outcomes of EMS patients are unknown. We seek to determine the long-term mortality of EMS patients in Denmark. METHODS: We analyzed linked EMS, hospital, and vital status data from 3 of 5 geographic regions in Denmark. We included events from July 1, 2011, to December 31, 2012. We classified EMS events according to primary dispatch category (unconsciousness/cardiac arrest, accidents/trauma, chest pain, dyspnea, neurologic symptoms, and other EMS patients)...
March 25, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28343155/more-than-just-muscle-spasms-a-rare-presentation-of-aortic-dissection
#10
Ebisa Bekele, Deepthi Chaitanya Kagolanu, Martin Kim, Kent Stephenson
Acute aortic dissection is associated with significant morbidity and mortality, often from complications including aortic regurgitation, cardiac tamponade and myocardial infarction. Typical clinical presentation includes a sudden onset of severe chest pain, although this is not always consistent. Clinical signs and symptoms are diverse with an estimated 38% of cases being missed on initial evaluation. Primary neurological symptoms at presentation are rare but have been reported often to coexist with chest pain...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28275422/concomitant-left-atrial-myxoma-and-patent-foramen-ovale-is-it-an-evolutional-synergy-for-a-cerebrovascular-event
#11
Glenmore Lasam, Roberto Ramirez
We report a case of a 48-year-old female who presented initially with an abrupt onset of left facial and hand numbness after her routine yoga with no associated syncope, palpitation, chest pain or dyspnea. She consulted her primary care physician and recommended hospital care for possible stroke. On the day of admission, she complained of left facial and hand hemiparesthesia. Cranial imaging and angiography were unremarkable but echocardiography and cardiac computed tomography revealed left atrial mass. She underwent resection of the left atrial mass with an incidental finding of patent foramen ovale intraoperatively...
February 2017: Cardiology Research
https://www.readbyqxmd.com/read/28275421/treating-a-structural-heart-disease-using-a-non-structural-approach-role-of-cardiac-pacing-in-hypertrophic-cardiomyopathy
#12
Bernard Benjamin P Albano, Erdie C Fadreguilan, Jeffrey M Chua, James Ho, Ana Beatriz Medrano
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease characterized by a thickened non-dilated ventricle in the absence of another cardiac or systemic condition. Its most important hemodynamic consequence is left ventricular outflow tract (LVOT) obstruction. The primary management strategy of this condition is surgical septal myectomy, but an acceptable alternative treatment in patients who are not suitable for (or who refuse) surgery is alcohol septal ablation (ASA). However, in patients with unfavorable coronary anatomy which precludes ASA (i...
February 2017: Cardiology Research
https://www.readbyqxmd.com/read/28270260/what-is-the-diagnostic-value-of-the-paediatric-exercise-tolerance-test-results-from-a-uk-centre
#13
Magdalena A Sajnach-Menke, Sarah C Walpole
Purpose The aim of this study was to determine whether the exercise tolerance test can provide diagnostic and prognostic information regarding children and young adults and help predict outcome. METHODS: A total of 87 patients, aged 7-29 years (median 13, mean 13.4) were selected retrospectively. They underwent exercise test at the Freeman Hospital from December, 2015 to May, 2016. There were two groups of patients - 46 had symptoms such as chest pain, palpitations, syncope, or dyspnoea on exertion and no cardiac diagnosis, and 40 patients had a cardiac diagnosis such as hypertrophic cardiomyopathy, transposition of the great arteries with post-arterial switch operation, aortic stenosis or regurgitation, tetralogy of Fallot, abnormal coronary arteries, Wolff-Parkinson-White syndrome, or supraventricular tachycardia...
March 8, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28262338/differences-in-presentation-management-and-outcomes-in-women-and-men-presenting-to-an-emergency-department-with-possible-cardiac-chest-pain
#14
Lorcan Ruane, Jaimi H Greenslade, William Parsonage, Tracey Hawkins, Christopher Hammett, Carolyn Sp Lam, Thomas Knowlman, Shaela Doig, Louise Cullen
BACKGROUND: Research suggests that female patients with acute coronary syndrome (ACS) experience delays in emergency department (ED) management and are less likely to receive guideline-based treatments and referrals for follow-up testing. Women are often found to have poorer clinical outcomes in comparison to men. This study aimed to assess current sex differences in the presentation, management and outcomes of patients with undifferentiated chest pain presenting to a tertiary ED. METHODS: Data were analysed from two prospective studies conducted at a single Australian site between 2007 and 2014...
February 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28261896/identifying-low-risk-patients-for-early-discharge-from-emergency-department-without-using-subjective-descriptions-of-chest-pain-insights-from-providing-rapid-out-of-hospital-acute-cardiovascular-treatment-proact-3-and-4-trials
#15
Nariman Sepehrvand, Yinggan Zheng, Paul W Armstrong, Robert C Welsh, Justin A Ezekowitz
BACKGROUND: Several accelerated diagnostic protocols (ADP) have been developed to allow emergency department (ED) physicians to identify appropriate patients for safe early discharge after presentation with symptom of chest pain. Most ADPs require chest pain to be described and modify the algorithm based on the subjective chest pain characteristics. We investigated the performance of 3 established major ADPs simplified by eliminating the need for chest pain as a descriptor. METHODS: We pooled patients from PROACT-3 and 4 trials, in which patients presenting to emergency medical services (EMS) with chest pain or dyspnea were enrolled...
March 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28260354/overlap-of-gerd-and-gastrointestinal-functional-disorders
#16
Nicola De Bortoli, Veronica Natali, Sara Melissari, Natalia Simonetti, Gherardo Tapete, Santino Marchi
The functional gastrointestinal disorders (FGIDs) are common conditions with an overall prevalence burden estimated at approximately one-third of the population. These represent a heterogeneous group of conditions which may include both abnormal symptom perception and functional causes and seems to share similar trigger factors as food, lifestyle and psychological factor. GERD develops when the reflux of gastric contents into the esophagus leads to troublesome symptoms, with or without mucosal involvement. Functional heartburn represents a subcategory of patients who refers with heartburn but without abnormal esophageal acid exposure, abnormal number of reflux events or any temporal correlation between symptoms and reflux events, on the same hands these patients do not report any symptom relief during antisecretory treatment with proton pump inhibitors...
March 3, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28256404/panic-disorder-in-patients-presenting-to-the-emergency-department-with-chest-pain-prevalence-and-presenting-symptoms
#17
Jaimi H Greenslade, Tracey Hawkins, William Parsonage, Louise Cullen
BACKGROUND: Patients with panic disorder experience symptoms such as palpitations, chest pain, dizziness, and breathlessness. Consequently, they may attend the Emergency Department (ED) to be assessed for possible emergency medical conditions. Recognition of panic disorder within the ED is low. We sought to establish the prevalence of panic disorder in patients presenting to the for ED investigation of potential acute coronary syndrome. We also sought to characterise the cohort of patients with panic disorder in terms of presenting symptoms, risk factors, medical history and major adverse cardiac events (MACE)...
February 16, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28244197/clinical-presentation-of-patients-with-spontaneous-coronary-artery-dissection
#18
Christina Luong, Andrew Starovoytov, Milad Heydari, Tara Sedlak, Eve Aymong, Jacqueline Saw
BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an infrequent but important cause of myocardial infarction (MI) especially in younger women. However, the clinical presentation and the acuity of symptoms prompting invasive management in SCAD patients have not been described. Understanding these presenting features may improve SCAD diagnosis and management. METHODS: We reviewed SCAD patients who were prospectively followed at the Vancouver General Hospital SCAD Clinic...
February 28, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28239994/aortic-stenosis-in-dialysis-patients
#19
REVIEW
Yousif Ahmad, Michael F Bellamy, Christopher S R Baker
Aortic valve stenosis occurs 10-20 years earlier in patients on dialysis compared with the general population. This is likely related to the exposure of the valve to a milieu that predisposes to calcification as well as increased shear stress across the valve. Objective assessment of stenosis severity is largely made using echocardiography though accurate interpretation requires an understanding of the potential pitfalls of the technique and the influence of cardiac output upon the gradient measured across the valve...
February 26, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28208923/long-term-outcome-in-patients-with-esophageal-stenting-for-cancer-esophagus-our-experience-at-a-rural-hospital-of-punjab-india
#20
Parvinder Singh, Abhitesh Singh, Anantbir Singh, Ghansham Sharma, Parmod Kumar Bhatia, Amarjeet Singh Grover
INTRODUCTION: Cancer of the esophagus is among the leading cause of cancer deaths in Punjab, India. Patients generally present with dysphagia as their first symptom and more often they have advanced disease at the time of presentation to a tertiary care centre. Palliative procedures have important roles in this setting. Stenting is the best option to palliate the symptoms of dysphagia, from which patient is suffering the most. AIM: To know the success rate, early and long term complications and mortality in esophageal stenting, when it was done in malignant esophageal stricture patients...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
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