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https://www.readbyqxmd.com/read/28644157/ecg-case-of-the-month-chest-pain-and-ecg-abnormalities
#1
D Luke Glancy
A 27-year-old man was admitted to the coronary care unit because of chest pain and an electrocardiogram (ECG) read by the computer as an inferior infarct and left ventricular hypertrophy (Figure).
May 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28643980/-hiatal-hernia-current-diagnostic-and-therapeutic-management
#2
Pierre Allemann, Valentine Guarnero, Alain Schoepfer, Nicolas Demartines, Markus Schäfer
Hiatal hernia is a frequent pathology. Two types have been described : sliding hernia and paraesophageal hernia (PEH). The first one is the most frequent and is associated with reflux disease. Patients with PEH have a large variety of symptoms, such as chest pain, dyspnea, regurgitation, iterative pneumonia and iron-deficiency anemia. Operative management is necessary for sliding hernia with reflux disease and for symptomatic PEH, respectively. In patients with asymptomatic PEH, operative risk must be balanced with the risk of postoperative complications...
June 14, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28643111/thymic-carcinoma-initially-presented-with-geographic-destruction-of-scapula-in-a-child
#3
Won-Jong Bahk, An-Hi Lee, Eun-Deok Chang, Dong-Wook Min, Yong-Koo Kang
As the conventional histopathologic examination of thymic carcinoma (TC) is nonspecific, immunohistochemical studies along with correlative radiographic investigations are needed for its correct diagnosis. TC commonly occurs in the late 5th to early 6th decades of life but is extremely rare in childhood. It may be incidentally detected from chest radiographs taken as routine or for other reasons. However, most patients present with symptoms such as chest pain, cough, shortness of breath, dysphagia and hoarseness, which are directly attributable to the mediastinal mass...
June 23, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28643007/the-role-of-lipofilling-after-breast-reconstruction-evaluation-of-outcomes-and-patient-satisfaction-with-breast-q
#4
Annalisa Cogliandro, Mauro Barone, Stefania Tenna, Marco Morelli Coppola, Paolo Persichetti
INTRODUCTION: The aim of this study was to measure patient satisfaction using the BREAST-Q reconstruction module in patients selected for lipofilling procedures after implant breast reconstructions. MATERIALS AND METHODS: Seventy patients who underwent breast reconstruction with or without delayed lipofilling were enrolled between 2011 and 2015, and they completed BREAST-Q surveys. We administered the questionnaire electronically 6 months and 1 year after surgery...
June 22, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28643006/complications-of-fat-transfer-for-breast-augmentation
#5
Paraskevas Kontoes, George Gounnaris
Autologous fat grafting is quite common for breast augmentations as well as for reconstructive breast surgery. Coleman has described the surgical technique of fat grafting. Fat is harvested, and after centrifugation and refinement, blunt infiltration cannulas are used to place the fat through small incisions. The grafted tissue is placed in small aliquots with each withdrawal of the cannula. In order to achieve an aesthetically pleasing contour of the breast, the fat should be layered into different levels from the chest wall to the skin...
June 22, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28638839/broken-heart-syndrome-in-a-patient-on-maintenance-hemodialysis
#6
Sukhdeep Bhogal, Vatsal Ladia, Puja Sitwala, Kailash Bajaj, Vijay Ramu, Timir Paul
Context:Broken heart syndrome or Takotsubo cardiomyopathy (TC) is a disorder characterized by transient left ventricular apical ballooning that almost invariably precedes emotional or physical stress. Although the patients with chronic kidney disease on hemodialysis have shown to exhibit sustained activity of sympathetic nervous system, the presentation of TC in these patients is a rare entity with few case reports in the literature. Case Report: A 75-year-old female with past medical history of end-stage renal disease presented with chest pressure and heaviness that started during her maintenance hemodialysis session...
April 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28638620/chest-pain-and-recurrent-chylothorax-an-unusual-presentation-of-malignant-pleural-mesothelioma
#7
David R Darley, Emily Granger, Allan R Glanville
Malignant mesothelioma presenting with recurrent chylous effusion is rare. We describe the case of a 34-year-old female Macedonian immigrant who presented with central chest pain and subsequently a left-sided chylous pleural effusion. The diagnosis was made on pleural biopsy via video-assisted thoracoscopic surgery (VATS). Our case demonstrates the utility of thoracic magnetic resonance imaging (MRI) and the difficulties associated with pleural cytology and cervical lymph node biopsy in the establishment of a diagnosis of mesothelioma...
September 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28638298/uncertainty-of-myocardial-perfusion-imaging-in-chest-pain-risk-stratification
#8
Htoo Kyaw, Sivacharan Buddhavarapu, Joseph Abboud, Deepika Misra
BACKGROUND: Chest pain is a common presenting symptom in the emergency department (ED). Although the diagnostic workup for chest pain is well established, the best time to perform invasive cardiac catheterization in patients with low to moderate risk of coronary artery disease is still unclear, particularly if noninvasive tests such as the electrocardiogram (ECG) and nuclear myocardial perfusion scan show nonsignificant findings. CASE REPORT: We present the case of a 52-year-old female who presented to the ED with acute-onset chest pain that had started early in the morning while she was sleeping...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28637780/sex-based-differences-in-the-performance-of-the-heart-score-in-patients-presenting-to-the-emergency-department-with-acute-chest-pain
#9
Ingrid E M Bank, Vince C de Hoog, Dominique P V de Kleijn, Gerard Pasterkamp, Pieter A Doevendans, Hester M den Ruijter, Geertje Dalmeijer, Thierry X Wildbergh, Arend Mosterd, Leo Timmers
BACKGROUND: Sex-based differences in clinical presentation, pathophysiology, and outcomes of patients with acute chest pain are increasingly being recognized, but are not implemented in guidelines and clinical prediction tools. We evaluated the performance of the HEART score in women versus men, because sex-based differences may exist among the algorithm's components: history, electrocardiogram, age, risk factors, and admission troponin level. METHODS AND RESULTS: The HEART score was retrospectively assessed in 831 women and 1084 men presenting to the emergency department with acute chest pain, assigning patients to the low-, intermediate-, or high-risk category for the occurrence of major adverse cardiac events (MACE) within 6 weeks...
June 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28637185/a-novel-method-of-open-reduction-and-internal-fixation-of-a-displaced-manubrial-fracture-using-distal-clavicle-locking-plates
#10
Daniel Miller, M Adeel Akhtar, Jonathan Fergusson, James L McVie
A 52-year-old man sustained a sternal fracture after a blunt traumatic chest injury. He was in severe pain in the intensive care unit, which resulted in difficulty breathing and increased analgesic requirement, and a decision was made to stabilize his manubrial fracture. Orthopaedic and thoracic surgeons jointly performed open reduction and internal fixation of the displaced manubrial fracture using 2 distal clavicle locking plates. This resulted in improvement in patient's pain and helped with his subsequent recovery and discharge from the hospital...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28637106/-a-case-of-hemorrhage-of-an-esophageal-duplication-cyst-improved-by-endoscopic-drainage
#11
In Sub Han, Gwang Ha Kim, Seong Jun Lee, Bong Eun Lee, Hoseok I, Yeong Dae Kim
Esophageal duplication cyst is a rare congenital gastrointestinal malformation. It is the second most common duplication cyst following small bowel duplication cyst in the gastrointestinal tract. Patients with an esophageal duplication cyst are generally asymptomatic; however, some patients may present the following symptoms: dysphagia, chest pain, stridor, unproductive cough, and epigastric discomfort by compression of the surrounding structures. Surgical removal is the treatment of choice in symptomatic cases and can be considered in asymptomatic cases if they are at risk for developing complications, such as ulceration or perforation...
June 25, 2017: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
https://www.readbyqxmd.com/read/28635200/unusual-symptomatic-late-onset-presentation-of-aberrant-right-subclavian-artery-report-of-two-cases-and-short-literature-review
#12
Yannis Dimitroglou, Ioannis Loulakas, Maria Chounti, Michail Megalakakis, Eleni Karavana, Panagiotis Hountis
Aberrant subclavian arteries are congenital vascular anomalies that usually do not cause any symptoms. When symptomatic they are considered as a rare cause of dysphagia. This presentation is known as dysphagia lusoria. They are diagnosed by barium swallow or contrast-enhanced computed tomography, although it may be an incidental finding. Management varies from life modifications and drug therapy to surgical intervention. We report two cases of the unusual form of late onset symptomatic presentation because of the presence of aberrant right subclavian artery...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28634541/campylobacter-jejuni-myocarditis-a-journey-from-the-gut-to-the-heart
#13
M Toba Obafemi, Homeyra Douglas
OBJECTIVES: Campylobacter jejuni is an unusual cause of myocarditis and could easily be missed. METHODS: We describe a case of a 25 year old man, who presented with 3 day history of vomiting and diarrhoea, followed by chest pain and significant high sensitive troponin rise. RESULTS: The patient's profuse diarrhoea was accompanied by raised inflammatory markers, electrocardiogram changes and evidence of cardiomyopathy on transthoracic echocardiogram...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28634529/duodenal-diverticulum-incidental-finding-with-potentially-dangerous-outcomes
#14
Stephen Melnick, Shoaib Fareedy, David Gish, Salik Nazir
We present the case of an 83-year-old woman with a past medical history significant for schizoaffective disorder, presenting to our emergency department with the complaint of 'pain'. Given the non-specific complaint and the limited history obtained, CT imaging was performed on her chest and abdomen which incidentally found a large duodenal diverticulum. This manuscript discusses the incidence of duodenal diverticula and the potential associated complications.
January 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28634285/frequency-of-chest-pain-in-primary-care-diagnostic-tests-performed-and-final-diagnoses
#15
Beatrijs Bn Hoorweg, Robert Ta Willemsen, Lotte E Cleef, Tom Boogaerts, Frank Buntinx, Jan Fc Glatz, Geert Jan Dinant
OBJECTIVE: Observational study of patients with chest pain in primary care: determination of incidence, referral rate, diagnostic tests and (agreement between) working and final diagnoses. METHODS: 118 general practitioners (GPs) in the Netherlands and Belgium recorded all patient contacts during  2weeks. Furthermore, patients presenting with chest pain were registered extensively. A follow-up form was filled in after 30 days. RESULTS: 22 294 patient contacts were registered...
June 20, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28633904/clinical-characteristics-of-type-a-acute-aortic-dissection-with-symptom-of-the-central-nervous-system
#16
Yuji Shono, Tomohiko Akahoshi, Satomi Mezuki, Kenta Momii, Noriyuki Kaku, Jun Maki, Kentaro Tokuda, Tetsuro Ago, Takanari Kitazono, Yoshihiko Maehara
BACKGROUND AND PURPOSE: Accurate diagnosis of acute aortic dissection (AAD) is sometimes difficult because of accompanying central nervous system (CNS) symptoms. The purpose of this study was to investigate the clinical characteristics of Type A AAD (TAAAD) with CNS symptoms. METHODS: We retrospectively reviewed the medical records of 8403 patients ambulanced to our emergency and critical care center between April 2009 and May 2014. RESULTS: We identified 59 TAAAD patients for the analysis (mean age, 67...
June 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28633709/primary-pulmonary-actinomycosis-a-retrospective-analysis-of-145-cases-in-mainland-china
#17
M Zhang, X-Y Zhang, Y-B Chen
OBJECTIVE: To improve our understanding of pulmonary actinomycosis. METHODS: A retrospective analysis of 145 cases in mainland China was conducted. RESULTS: The male:female ratio was 2.7:1. Mean age at diagnosis was 48 years (± 12). Main symptoms were cough (87.6%), expectoration (40%), blood-stained sputum (37.2%), fever (26.9%), chest pain (24.8%) and haemoptysis (16.6%). Eighty-eight (60.7%) patients had no underlying disease. Only five patients received a correct initial diagnosis; 60 patients were misdiagnosed with lung cancer, followed by pulmonary tuberculosis (TB) and lung abscess...
July 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28631648/leiomyosarcoma-of-inferior-vena-cava-with-intracardiac-extension-presenting-as-budd-chiari-syndrome-report-of-a-rare-case
#18
Kaniyappan Nambiyar, Arvind Ahuja, Minakshi Bhardwaj
Primary leiomyosarcoma of vascular origin is a rare malignant smooth muscle tumor. This report describes a case of primary leiomyosarcoma of the inferior vena cava (IVC) in a 52-year-old male who presented with complaints of abdominal pain, chest pain, and bilateral lower limb swelling for 4 months. Imaging of the chest and abdomen revealed a mass in the IVC extending into right atrium, heterogeneous enhancement of liver, hepatosplenomegaly, and ascites. Histopathological examination showed a malignant spindle cell tumor with cells arranged in fascicular and hemangiopericytomatous pattern...
April 2017: Indian Journal of Pathology & Microbiology
https://www.readbyqxmd.com/read/28631459/could-the-new-ultrasound-guided-erector-spinae-plane-block-be-a-valid-alternative-to-paraverteral-block-in-chest-chronic-pain-syndromes
#19
Pierfrancesco Fusco, Stefano DI Carlo, Paolo Scimia, Antonio Luciani, Emiliano Petrucci, Franco Marinangeli
No abstract text is available yet for this article.
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28630845/multi-foci-salmonella-enteritis-osteomyelitis-of-thoracic-spine-with-pleural-effusion-and-fatal-outcome-a-unique-case-presentation-and-review-of-the-literature
#20
Ioannis Papaioannou, Andreas Baikousis, Panagiotis Korovessis
INTRODUCTION: A case of thoracic vertebral osteomyelitis due to Salmonella enteritis (SE) in an immunocompetent patient is reported. This is the third case in the literature of SE thoracic vertebral osteomyelitis, but the first one with this multi-foci presentation and finally fatal outcome due to meningoencephalitis. Further data that makes our case unique are the absence of fever (body temperature: 37.4°C) and gastrointestinal disorders. CASE REPORT: A 57-year-old male patient initially presented with thoracic pain, dyspnea, and knee pain...
January 2017: Journal of Orthopaedic Case Reports
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