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Cardiac chest pain symptoms

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https://www.readbyqxmd.com/read/29163951/coronary-artery-anomalies-unusually-high-incidence-of-anomalies-with-a-malignant-course-in-an-asian-population
#1
Abdulaziz M Alkhulaifi, Nidheesh Chooriyil, Maryam Alkuwari, Abdelnasser N Ghareep, Cornelia Carr
Objectives: Coronary artery anomalies are uncommon, but important cardiac malformations, representing the second commonest cause of death in young athletes. Methods: We utilized computerized tomographic angiography to screen and precisely delineate coronary artery anomalies in patients with minimal cardiac symptoms. Results: During 3.5-year period, we performed 2888 computerized tomographic angiographies. A total of 33 (1.1%; 95% confidence interval = 0...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/29153816/a-decreased-preload-due-to-a-loaded-stomach-a-rare-presentation-of-a-paraesophageal-hernia
#2
Rens A van der Linde, Seilenna S Lases, Thomas J Buist, Henderik L van Westreenen, Vincent B Nieuwenhuijs
A hiatal hernia is a condition in which intraabdominal content herniates into the intrathoracic cavity. On rare occasions, a hiatal hernia can lead to cardiorespiratory compromise. We report a case of chest pain followed by cardiac arrest in a patient not known to have hiatal hernia, and without preliminary symptoms. The patient was suspected of having cardiac ischemia; however, angiography did not reveal any abnormalities. Chest tomography revealed a large paraesophageal hernia with compression of the right ventricle causing decreased preload and cardiac output...
December 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29138234/mesalazine-induced-myopericarditis-in-a-patient-with-ulcerative-colitis
#3
Jalal Asadi, Sanjay S Bhandari, Nauman Ahmed
A 25-year-old male with a background of ulcerative colitis presented with a two-week history of central chest pain. His ECG on presentation showed global T wave inversion with a peak troponin I of 165 ng/ml. Clinical diagnosis of myopericarditis/myocarditis was made. Echocardiography and cardiac MR confirmed the diagnosis. On detailed assessment of his medication history, mesalazine was suspected as an aetiological factor, with discontinuation resulting in an improvement in symptoms, inflammatory markers and cardiac enzymes...
November 14, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/29131477/a-risk-assessment-score-and-initial-high-sensitivity-troponin-combine-to-identify-low-risk-of-acute-myocardial-infarction-in-the-emergency-department
#4
John W Pickering, Dylan Flaws, Stephen W Smith, Jaimi Greenslade, Louise Cullen, William Parsonage, Edward Carlton, A Mark Richards, Richard Troughton, Christopher Pemberton, Peter M George, Martin P Than
OBJECTIVES: Early discharge of patients with presentations triggering assessment for possible acute coronary syndrome is safe when clinical assessment indicates low-risk, biomarkers are negative, and electrocardiograms (ECGs) are non-ischemic. We hypothesized that the Emergency Department Assessment of Chest Pain Score (EDACS) combined with a single measurement of high-sensitivity cardiac troponin (hs-cTn) could allow early discharge of a clinically meaningful proportion of patients. METHODS: We pooled data from 4 patient cohorts from New Zealand and Australia presenting to an ED with symptoms suggestive of ACS...
November 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29123621/a-hybrid-cardiac-rehabilitation-is-as-effective-as-a-hospital-based-program-in-reducing-chest-pain-intensity-and-discomfort
#5
Mozhgan Saeidi, Ali Soroush, Saeid Komasi, Puneetpal Singh
Background: Health care services effort to provide alternative cardiac rehabilitation (CR) models to serve patients according to their preferences and needs. So, the present study aimed to assess and compare the effects of hospital-based and hybrid CR programs on chest pain intensity and discomfort in cardiac surgery patients. Methods: In this prospective study, 110 cardiac surgery patients were invited to the CR department of a hospital in the western part of Iran between March and July 2016...
October 2017: Korean Journal of Pain
https://www.readbyqxmd.com/read/29117666/prognostic-significance-of-non-chest-pain-symptoms-in-patients-with-non-st-segment-elevation-myocardial-infarction
#6
Inna Kim, Min Chul Kim, Keun Ho Park, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Jeong Gwan Cho, Jong Chun Park, Myeong Chan Cho, Jong Jin Kim, Young Jo Kim, Youngkeun Ahn
Background/Aims: Chest pain is an essential symptom in the diagnosis of acute coronary syndrome (ACS). One-third of patients with ACS present atypically, which can influence their receiving timely lifesaving therapy. Methods: A total of 617 NSTEMI patients from the Korea Acute MI Registry (KAMIR) and the Korea Working Group on MI (KorMI) databases were analyzed. The study population was divided into two groups by symptoms at presentation (typical symptoms group, 128; atypical symptoms groups, 128)...
November 10, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29115767/care-delays-in-patients-with-signs-and-symptoms-of-acute-myocardial-infarction
#7
Susan Sanders
AIM: More than six million patients with signs and symptoms suggestive of a heart attack present to emergency departments (EDs) in the US each year. Of those diagnosed with acute myocardial infarction (AMI), one third die in the acute phase. Rapid ED triage can reduce the mortality rate, yet there are still delays in patient care. The aim of this study is to explore the relationship between patient and nurse characteristics, patient presentations, delays in triage, and delays in obtaining electrocardiograms (ECGs) of patients with signs and symptoms of AMI...
October 12, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/29114418/stop-being-so-sensitive-an-exceptionally-rare-report-of-ustekinumab-induced-sub-acute-hypersensitivity-pneumonitis
#8
Azka Ali, Jason Chertoff, Christopher Harden, Dara Wakefield, James Wynne
Hypersensitivity pneumonitis (HSP) is a rare syndrome characterised by granulomatous inflammatory lung disease due to repeated sensitisation from a specific antigen. We present the case of a 61-year old male veteran with a history of nodular eczema who presented with 2 weeks of progressive dyspnoea on exertion and pleuritic chest pain. The patient was started on ustekinumab 5 weeks prior to presentation. Initial workup revealed ground-glass opacities on computed tomography (CT) scan of the chest. Cardiac workup was unrevealing with a normal myocardial perfusion stress test...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29096885/stress-induced-cardiomyopathy-in-cancer-patients
#9
Dana Elena Giza, Juan Lopez-Mattei, Pimprapa Vejpongsa, Ezequiel Munoz, Gloria Iliescu, Danai Kitkungvan, Saamir A Hassan, Peter Kim, Michael S Ewer, Cezar Iliescu
Takotsubo syndrome, also known as stress-induced cardiomyopathy (SC), is underrecognized in cancer patients. This study aims to investigate the incidence, natural history, and triggers of SC in cancer patients and its impact on cancer therapy and overall survival. A total of 30 subjects fulfilled the diagnostic criteria for SC at MD Anderson Cancer Center over a 6-year period. Clinical presentation, electrocardiogram, laboratory data, and transthoracic echocardiogram results registered during the acute phase and follow-up were collected...
September 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29079674/myocardial-bridge-bridging-the-differential-diagnosis
#10
Mayur Patel, Brenen Swofford, Edward Distler
A 50-year-old man with a history of vasospastic angina diagnosed 3 months prior presented with recurrent episodes of substernal chest pain. His chest pain was characterised as 'squeezing', lasting 10 min and typically occurred on awakening. Medications included isosorbide, nitroglycerin and ranolazine; however, due to lack of insurance he was unable to obtain these medications. On admission, patient was given a full-dose aspirin and nitroglycerin, which acutely worsened his chest pain. ECG did not reveal ischaemic changes and initial troponin was negative...
October 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29079376/validation-of-the-troponin-only-manchester-acute-coronary-syndromes-decision-aid-with-a-contemporary-cardiac-troponin-i-assay
#11
Patricia Va Den Berg, Gillian Burrows, Philip Lewis, Simon Carley, Richard Body
OBJECTIVES: The Manchester Acute Coronary Syndromes (MACS) decision aid can 'rules in' and 'rule out' acute coronary syndromes (ACS) by combining a patient's symptoms with the results of a single blood test taken at the time of arrival in the Emergency Department (ED). The original model (MACS) included two biomarkers: high sensitivity cardiac troponin T (hs-cTnT) and heart-type fatty acid binding protein (h-FABP). A refined model without h-FABP was found to have comparable sensitivity but greater specificity...
September 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29076052/assessment-of-acute-myocarditis-by-cardiac-magnetic-resonance-imaging-comparison-of-qualitative-and-quantitative-analysis-methods
#12
Massimo Imbriaco, Carmela Nappi, Marta Puglia, Marco De Giorgi, Serena Dell'Aversana, Renato Cuocolo, Andrea Ponsiglione, Igino De Giorgi, Maria Vincenza Polito, Michele Klain, Federico Piscione, Leonardo Pace, Alberto Cuocolo
BACKGROUND: To compare cardiac magnetic resonance (CMR) qualitative and quantitative analysis methods for the noninvasive assessment of myocardial inflammation in patients with suspected acute myocarditis (AM). METHODS: A total of 61 patients with suspected AM underwent coronary angiography and CMR. Qualitative analysis was performed applying Lake-Louise Criteria (LLC), followed by quantitative analysis based on the evaluation of edema ratio (ER) and global relative enhancement (RE)...
October 26, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29066079/diagnosis-of-aortic-dissection-presenting-as-st-elevation-myocardial-infarction-using-point-of-care-ultrasound
#13
Jordan Chenkin
BACKGROUND: Aortic dissections can present with a broad spectrum of signs and symptoms, making them difficult to diagnose in the emergency department (ED). Aortic dissections can cause occlusion of the coronary arteries, mimicking an acute ST-elevation myocardial infarction (STEMI). Emergency point-of-care ultrasound (POCUS) may be a useful diagnostic tool to help differentiate aortic dissection from a primary myocardial infarction. CASE REPORT: A 69-year-old man with no medical history presented to our ED complaining of chest pain...
October 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29064969/clinical-updates-in-women-s-health-care-summary-ischemic-heart-disease-primary-and-preventive-care-review
#14
REVIEW
Brittany S Fuller, Lynn Carlyle, Michele D Voeltz
Cardiovascular disease is the leading cause of death among women in the United States. Obstetrician-gynecologists often are the sole health care providers for otherwise healthy women. Therefore, they must be aware of risk factors, signs, and symptoms of cardiovascular disease and be prepared to recognize and treat this condition in patients as well as provide referrals when specialized care is indicated. Women with cardiac problems typically present with chest discomfort; however, they also are more likely than healthy women to present with other common symptoms, such as shortness of breath, back pain, jaw pain, or nausea and vomiting...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29039623/the-challenge-of-takotsubo-syndrome-heterogeneity-of-clinical-features
#15
Susanne Anna Schlossbauer, Jelena-Rima Ghadri, Frank Scherff, Christian Templin
Takotsubo syndrome (TTS) was first described in 1991 as a rare, spontaneous and completely reversible left ventricular regional systolic dysfunction. Today the incidence of TTS is estimated at 2% in patients with an initial diagnosis of acute coronary syndrome (ACS). Notably, the incidence can be as high as 5.9 to 7.5% in female patients. TTS occurs predominantly in postmenopausal women, but both sexes may be affected, at any age. Acute chest pain or dyspnoea is a characteristic symptom of TTS, but initial presentation can also include more severe disease manifestation such as acute heart failure with pulmonary oedema or haemodynamic instability, especially in an in-hospital setting...
October 17, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29029109/early-diagnosis-of-acute-coronary-syndrome
#16
Hugo Katus, André Ziegler, Okan Ekinci, Evangelos Giannitsis, Wendy Gattis Stough, Stephan Achenbach, Stefan Blankenberg, Martina Brueckmann, Paul Collinson, Dorin Comaniciu, Filippo Crea, Wilfried Dinh, Grégory Ducrocq, Frank A Flachskampf, Keith A A Fox, Matthias G Friedrich, Kathy A Hebert, Anders Himmelmann, Mark Hlatky, Dominik Lautsch, Bertil Lindahl, Daniel Lindholm, Nicholas L Mills, Giorgio Minotti, Martin Möckel, Torbjørn Omland, Véronique Semjonow
The diagnostic evaluation of acute chest pain has been augmented in recent years by advances in the sensitivity and precision of cardiac troponin assays, new biomarkers, improvements in imaging modalities, and release of new clinical decision algorithms. This progress has enabled physicians to diagnose or rule-out acute myocardial infarction earlier after the initial patient presentation, usually in emergency department settings, which may facilitate prompt initiation of evidence-based treatments, investigation of alternative diagnoses for chest pain, or discharge, and permit better utilization of healthcare resources...
November 1, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29019475/orofacial-pain-associated-with-vasospastic-angina-a-case-report
#17
Makoto Adachi, Mio Hayashi, Tomonori Segawa, Takahiko Yamaki, Yasunori Muramatsu, Shinichiro Sumitomo
The primary symptom of ischemic heart disease is typically chest pain, but in some cases, this pain may radiate to the maxillofacial region. This article describes the case of a 44-year-old man with orofacial pain of cardiac origin. The patient was suspected to be suffering from cardiac disease by the oral and maxillofacial surgeon and was referred to a cardiologist, where he received a heart examination. The patient was diagnosed by means of cardiac catheterization as having coronary spastic angina. During catheterization, intracoronary ergonovine maleate induced orofacial pain that was almost the same in character and intensity as the patient's first episode...
2017: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/29016562/determinants-of-the-association-between-non-cardiac-chest-pain-and-reflux
#18
Thomas V K Herregods, Albert J Bredenoord, Jacobus M Oors, Auke Bogte, André J P M Smout
OBJECTIVES: Gastroesophageal reflux is considered to be the most common gastrointestinal cause of non-cardiac chest pain (NCCP). It remains unclear why some reflux episodes in the same patient cause chest pain while others do not. To understand more about the mechanisms by which reflux elicits chest pain, we aimed to identify factors which are important in triggering chest pain. METHODS: In this multicenter study, 120 patients with NCCP were analyzed using 24-h pH-impedance monitoring...
November 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28986648/acute-myocarditis-with-infarct-like-presentation-in-a-pediatric-population-role-of-cardiovascular-magnetic-resonance
#19
Maria Martinez-Villar, Ferran Gran, Anna Sabaté-Rotés, Antonio Tello-Montoliu, Amparo Castellote, Marc Figueras-Coll, Queralt Ferrer, Ferran Roses-Noguer
Chest pain is a typical symptom of acute myocarditis in adolescents. It may be indistinguishable from myocardial ischemia so it is called "infarct-like pattern." Cardiovascular magnetic resonance has an important role as a non-invasive diagnostic tool. The aim of our study is to provide a description of an acute myocarditis series with infarct-like pattern and to evaluate the cardiovascular magnetic resonance role in a pediatric population. We included all pediatric patients (0-16 years) admitted to our hospital (May 2007-May 2016) with clinical diagnosis of acute myocarditis and infarct-like presentation (chest pain, EKG alterations, and released cardiac biomarkers)...
October 6, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28977415/hospital-volumes-and-later-year-of-operation-correlates-with-better-outcomes-in-acute-type-a-aortic-dissection
#20
Arnar Geirsson, Anders Ahlsson, Anders Franco-Cereceda, Simon Fuglsang, Jarmo Gunn, Emma C Hansson, Vibeke Hjortdal, Kati Jarvela, Anders Jeppsson, Ari Mennander, Shahab Nozohoor, Christian Olsson, Emily Pan, Anders Wickbom, Igor Zindovic, Tomas Gudbjartsson
OBJECTIVES: Acute Type A aortic dissection remains a life-threatening disease, but there are indications that its surgical mortality is decreasing. The aim of this report was to study how surgical mortality has changed and what influences those changes. METHODS: Nordic Consortium for Acute Type A Aortic Dissection is a retrospective database comprising 1159 patients (mean age 61.6 ± 12.2 years, 68% male) treated for acute Type A aortic dissection at 8 centres in Denmark, Finland, Iceland and Sweden from 2005 to 2014...
July 25, 2017: European Journal of Cardio-thoracic Surgery
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