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https://www.readbyqxmd.com/read/28925655/pleuritic-chest-pain-sorting-through-the-differential-diagnosis
#1
Brian V Reamy, Pamela M Williams, Michael Ryan Odom
Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling. Pulmonary embolism is the most common serious cause, found in 5% to 21% of patients who present to an emergency department with pleuritic chest pain. A validated clinical decision rule for pulmonary embolism should be employed to guide the use of additional tests such as d-dimer assays, ventilation-perfusion scans, or computed tomography angiography. Myocardial infarction, pericarditis, aortic dissection, pneumonia, and pneumothorax are other serious causes that should be ruled out using history and physical examination, electrocardiography, troponin assays, and chest radiography before another diagnosis is made...
September 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28924519/acute-pericarditis-descriptive-study-and-etiology-determination-in-a-predominantly-african-american-population
#2
Ahmad Awan, Fasil Tiruneh, Priscilla Wessly, Akbar Khan, Hasan Iftikhar, Sydney Barned, Daniel Larbi
INTRODUCTION ---Acute pericarditis is the most commonly encountered manifestation of pericardial disease (incidence: 0.2 percent to 0.5 percent in hospitalized patients). However, data regarding manifestations, workup, and the management of acute pericarditis in the African American population is lacking. This study aims to collect and analyze more clinical data related to acute pericarditis in this understudied population. METHODOLOGY We conducted a retrospective chart review of all patients managed for acute pericarditis at a university hospital serving a predominantly African American population...
July 6, 2017: Curēus
https://www.readbyqxmd.com/read/28918410/-just-like-a-normal-pain-what-do-people-with-diabetes-mellitus-experience-when-having-a-myocardial-infarction-a-qualitative-study-recruited-from-uk-hospitals
#3
Nikita Berman, Melvyn Mark Jones, Daan A De Coster
OBJECTIVE: The objective of the study was to investigate the symptoms people with diabetes experience when having a myocardial infarction (MI), their illness narrative and how they present their symptoms to the health service. SETTING: Three London (UK) hospitals (coronary care units and medical wards). PARTICIPANTS: Patients were recruited with diabetes mellitus (DM) (types 1 and 2) with a clinical presentation of MI (ST elevated MI (STEMI), non-ST elevated MI (NSTEMI), acute MI unspecified and cardiac arrest)...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28916174/evaluation-of-beat-to-beat-ventricular-repolarization-lability-from-standard-12-lead-ecg-during-acute-myocardial-ischemia
#4
Salah S Al-Zaiti, Mohammad Alrawashdeh, Christian Martin-Gill, Clifton Callaway, David Mortara, Jan Nemec
BACKGROUND: Acute myocardial ischemia is a common cause of ventricular arrhythmias, yet recent ECG methods predicting susceptibility to ventricular tachyarrhythmia have not been fully evaluated during spontaneous ischemia. We sought to evaluate the clinical utility of alternans and non-alternans components of repolarization variability from the standard 10-second 12-lead ECG signals to risk stratify patients with acute chest pain. METHODS: We enrolled consecutive, non-traumatic, chest pain patients transported through Emergency Medical Services (EMS) to three tertiary care hospitals with cardiac catheterization lab capabilities in Pittsburgh, PA...
August 10, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28915139/left-and-right-ventricular-morphology-function-and-late-gadolinium-enhancement-extent-and-localization-change-with-different-clinical-presentation-of-acute-myocarditis-data-from-the-italian-multicenter-study-on-myocarditis-itamy
#5
Gianluca Di Bella, Giovanni Camastra, Lorenzo Monti, Santo Dellegrottaglie, Paolo Piaggi, Claudio Moro, Alessia Pepe, Chiara Lanzillo, Gianluca Pontone, Martina Perazzolo Marra, Mauro Di Roma, Alessandra Scatteia, Giovanni D Aquaro
AIMS: Poor data exist about cardiac magnetic resonance (CMR) findings in a large sample of acute myocarditis with different clinical presentations (heart failure, arrhythmias, and infarct-like presentation). METHODS: Five hundred and forty-three in-patients with a clinical suspected of acute myocarditis confirmed by CMR were enrolled. The clinical indications to perform CMR were chest pain and/or dyspnea and/or palpitations, or effort intolerance/malaise in the last month; elevated troponin and/or new ventricular dysfunction, and/or new ECG abnormalities; and suspected inflammatory cause...
September 14, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28913922/a-clinically-meaningful-fetal-hemoglobin-threshold-for-children-with-sickle-cell-anemia-during-hydroxyurea-therapy
#6
Jeremie H Estepp, Matthew P Smeltzer, Guolian Kang, Chen Li, Winfred C Wang, Christina Abrams, Banu Aygun, Russell E Ware, Kerri Nottage, Jane S Hankins
Hydroxyurea has proven clinical benefits and is recommended to be offered to all children with sickle cell anemia (SCA), but the optimal dosing regimen remains controversial. Induction of red blood cell fetal hemoglobin (HbF) by hydroxyurea appears to be dose-dependent. However, it is unknown whether maximizing HbF% improves clinical outcomes. HUSTLE (NCT00305175) is a prospective observational study with a primary goal of describing the long-term clinical effects of hydroxyurea escalated to maximal tolerated dose (MTD) in children with SCA...
September 14, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28913755/management-and-clinical-outcome-of-stable-coronary-artery-disease-in-austria-results-from-5%C3%A2-years-of-the-clarify-registry
#7
Irene M Lang, Roza Badr-Eslam, Nicola Greenlaw, Robin Young, Philippe Gabriel Steg
BACKGROUND: The population of patients with established coronary artery disease (CAD) is growing because of an improvement in outcomes and survival from acute disease episodes. Nevertheless, these patients remain at high risk of cardiovascular events. Thus, CAD management is important in prevention of disease progression. The objective of this analysis was to describe disease management and clinical outcome of Austrian outpatients with stable CAD over 5 years by using data from the international CLARIFY registry...
September 14, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28905210/impact-of-pharmacological-spasm-provocation-test-in-patients-with-a-history-of-syncope
#8
Shozo Sueda, Hiroaki Kohno
Coronary artery spasm is involved in the pathogenesis of various cardiac disorders. We investigated patients with a history of syncope who underwent elective coronary angiography. We retrospectively analyzed 5781 consecutive patients who had diagnostic or follow-up angiography during a 26-year period. During this period, we found 95 patients with a history of syncope before elective coronary angiography. Pharmacological spasm provocation testing was performed in 64 patients with a history of syncope (<1 year)...
September 13, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28904792/desmoplastic-small-round-cell-tumors-of-the-pleura-a-review-of-the-clinical-literature
#9
REVIEW
Alessandro Giuseppe Fois, Pietro Pirina, Antonella Arcadu, Francesca Becciu, Sandra Manca, Viviana Marras, Sara Canu, Gaetano Castagna, Giorgio Carlo Ginesu, Angelo Zinellu, Panagiotis Paliogiannis
Desmoplastic small round cell tumor of the pleura is a rare malignancy, with only a few cases reported in the scientific literature. The aim of the present review is to discuss the demographic, pathological, clinical, and therapeutic features of this rare tumor. English-language articles published since 1989, when the first case of desmoplastic small round cell tumor of the pleura was described, were retrieved, and fifteen cases included in fourteen articles were revised. The mean age of the patients was 25...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28904706/-when-the-denture-becomes-dangerous
#10
Nouzha Sadak, Laila Herrak, Leila Achachi, Mustapha El Ftouh
Although rare in adults, foreign body aspiration (FBA) is a serious accident which can be potentially life threatening or lead to significant sequelae. We report the case of a 50 year old patient without previous pathological history, presenting to the emergency department with chest pain, intermittent cough and exertional dyspnea occurring six days after the accidental aspiration of his plastic dental prosthesis during a meal. Clinical examination was unremarkable. Chest X-ray as well as abdominal x-ray requiring no prior preparation showed no abnormalities...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28904677/-pulmonary-nocardiosis-in-immunocompetent-patients-about-2-cases
#11
Yasmina Rhofir, Rachida Zahraoui, Nabil Tiress, Hicham Naji-Amrani, Mouna Soualhi, Jamal Eddine Bourkadi
Nocardiosis is a rare but severe infection caused by bacteria of the genus nocardia, which belong to the order actinomycetales. If they can affect immunocompetent adult, nocardioses are pathologies affecting the individuals with weakened immune system. Pulmonary involvement is the most common manifestation, its correct management is based on diagnosis, which is often delayed due to non-specific symptoms and inconclusive specimens. We here report two cases of nocardiosis in immunocompetent patients. The first case concerns a 24-year old man with a history of smoking and alcoholism, hospitalized for chest pain and hemoptysis of low abundance evolving for two months, associated with the occurrence of dorsal subcutaneous fistulized abscess...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28904659/-pulmonary-embolism-at-the-university-hospital-campus-of-lome-togo-a-retrospective-study-about-51-cases
#12
Soulemane Pessinaba, Yaovi Dodzi Molba Atti, Soodougoua Baragou, Machihude Pio, Yaovi Afassinou, Mohamed Kpélafia, Edem Goeh-Akué, Findibé Damorou
INTRODUCTION: This study provides an analysis of the evolutionary, clinical and epidemiological aspects of pulmonary embolism at the University Hospital Campus of Lome. METHODS: We conducted a retrospective, analytic and descriptive study over a period of 39 months (November 1 , 2011- January 31, 2015). All the medical records of patients hospitalized for PE in the Department of Cardiology at the University Hospital Campus were analyzed. RESULTS: The prevalence of PE was 3...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28904006/the-crash-report-emergency-management-dilemmas-facing-acute-physicians-in-patients-with-pulmonary-arterial-hypertension
#13
Laura C Price, Konstantinos Dimopoulos, Philip Marino, Rafael Alonso-Gonzalez, Colm McCabe, Aleksander Kemnpy, Lorna Swan, Maria Boutsikou, Ahmed Al Zahrani, Gerry J Coghlan, Benjamin E Schreiber, Luke S Howard, Rachel Davies, Mark Toshner, Joanna Pepke-Zaba, Alistair C Church, Andrew Peacock, Paul A Corris, James L Lordan, Sean Gaine, Robin Condliffe, David G Kiely, Stephen John Wort
Treatment of acute emergencies in patients with pulmonary arterial hypertension (PAH) can be challenging. In the UK and Ireland, management of adult patients with PAH is centred in eight nationally designated pulmonary hypertension (PH) centres. However, many patients live far from these centres and physicians in local hospitals are often required to manage PAH emergencies. A committee of physicians from nationally designated PH centres identified the 'most common' emergency clinical scenarios encountered in patients with PAH...
September 12, 2017: Thorax
https://www.readbyqxmd.com/read/28900525/a-case-of-legionella-pneumophila-evaluated-with-ct-and-ultrasound
#14
Alessio D'Angelo, Chiara De Simone, Marco Pagnottella, Stefano Rossi, Raffaele Pepe, Giacomo Ruggieri, Giulio Cocco, Cosima Schiavone
A 36-year-old man was admitted to the emergency department of "SS Annunziata" hospital in Chieti complaining of a sharp chest pain arisen some hours before admission. On examination, the patient looked sweaty; his vital signs showed tachycardia and augmented breath rate; sinus tachycardia and normal ventricular repolarization were observed on ECG, and no abnormalities were observed in the echoscan of the hearth. According to the clinical and electrocardiographic findings, and to previous episode of DVT in anamnesis, a thorax CT scan was performed in order to rule out pulmonary embolism...
September 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28898794/surgical-management-of-late-bullet-embolization-from-the-abdomen-to-the-right-ventricle-case-report
#15
Ramos Mayo Alan Elison, Diaz Elizondo Jose Antonio, Segura Marin Hector, Lopez Garnica Dolores, Treviño Garza Francisco Xavier
INTRODUCTION: Secondary embolus from gun projectile is a rare entity, it represents a clinical and therapeutic dilemma because the potential complications involving central and peripheral circulation. Each case reported in the literature represents a challenge because their unique and different clinical scenarios. PRESENTATION OF CASE: We present the management of a 33-year-old man with past history of a gunshot wound on left flank with no evidence of any exit wounds, treated with exploratory laparotomy without removing the gunshot bullet from the abdomen...
September 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28894365/photothermal-ablation-of-inflammatory-breast-cancer-tumor-emboli-using-plasmonic-gold-nanostars
#16
Bridget M Crawford, Ronnie L Shammas, Andrew M Fales, David A Brown, Scott T Hollenbeck, Tuan Vo-Dinh, Gayathri R Devi
Inflammatory breast cancer (IBC) is rare, but it is the most aggressive subtype of breast cancer. IBC has a unique presentation of diffuse tumor cell clusters called tumor emboli in the dermis of the chest wall that block lymph vessels causing a painful, erythematous, and edematous breast. Lack of effective therapeutic treatments has caused mortality rates of this cancer to reach 20%-30% in case of women with stage III-IV disease. Plasmonic nanoparticles, via photothermal ablation, are emerging as lead candidates in next-generation cancer treatment for site-specific cell death...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28891551/mondor-s-disease-of-the-breast-in-a-nigerian-woman-previously-treated-for-invasive-ductal-carcinoma-in-the-contralateral-breast-a-case-report
#17
S A Olarinoye-Akorede, B T Silas
Mondor's disease is a self-limiting sclerosing angitis mostly affecting the superficial veins of the breast and chest wall. It is seldom diagnosed, and its etiology and epidemiology are speculative. However, numerous predisposing factors including breast cancer have been postulated. In Nigerian literature, only two cases have been documented to the best of our knowledge. This report is aimed at reminding breast specialists to include it as a diagnostic consideration in patients presenting with a breast lump in the appropriate clinical setting...
August 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28888269/depression-is-associated-with-recurrent-chest-pain-with-or-without-coronary-artery-disease-a-prospective-cohort-study-in-the-emergency-department
#18
Yeunjung Kim, Morgan Soffler, Summer Paradise, Qurat-Ul-Ain Jelani, James Dziura, Rajita Sinha, Basmah Safdar
BACKGROUND: Only a small fraction of acute chest pain in the emergency department (ED) is due to obstructive coronary artery disease (CAD). ED chest pain remains associated with high rates of recidivism, often in the presence of nonobstructive CAD. Psychological states such as depression, anxiety, and elevation of perceived stress may account for this finding. The objective of the study was to determine whether psychological states predict recurrent chest pain (RCP). METHODS: We conducted a prospective cohort study of low- to moderate-cardiac risk ED patients admitted to the Yale Chest Pain Center with acute chest pain...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28884631/takotsubo-cardiomyopathy-associated-with-paragonimiasis-westermani
#19
Ryouhei Matsuoka, Jun Muneuchi, Yusaku Nagatomo, Daisuke Shimizu, Seigo Okada, Chiaki Iida, Hiromitsu Shirouzu, Mamie Watanabe, Yasuhiko Takahashi, Haruhiko Maruyama
An 11-year-old boy collapsed during morning assembly at his junior high school. The automated external defibrillator detected ventricular fibrillation and provided shock delivery. He was successfully resuscitated and reverted to sinus rhythm. Electrocardiography showed ST-T elevation in the precordial leads. Echocardiography and angiography demonstrated akinesia of the apex and mid-wall of the left ventricle with preserved contraction of the basal segments, which suggested Takotsubo cardiomyopathy. The patient and his family had often eaten uncooked crab, and his father had a past history of infection with Paragonimiasis westermani...
September 8, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28882941/anomalous-left-anterior-descending-artery-arising-from-the-pulmonary-trunk-a-rare-cause-of-angina
#20
Abdalla Ibrahim, Stephen P Power, Peter Kelly
A 60-year-old man with a medical history of hypertension and dyslipidaemia presented to our rapid access chest pain clinic with a 2-month history of chest pain on exertion. An exercise stress test was arranged, which showed electrical evidence of inducible ischaemia. Subsequently, a coronary angiogram revealed an anomalous left anterior descending artery arising from the main pulmonary artery that received grade 3 collaterals from a large right coronary artery arising from the aorta. The circumflex arises from the right coronary sinus with a retroaortic course and provided collaterals to the anomalous left anterior descending artery...
September 7, 2017: BMJ Case Reports
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