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https://www.readbyqxmd.com/read/28633904/clinical-characteristics-of-type-a-acute-aortic-dissection-with-symptom-of-the-central-nervous-system
#1
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/28630838/a-case-report-of-an-unusual-case-of-tuberculous-osteomyelitis-causing-spontaneous-pathological-fracture-of-humerus-in-a-middle-aged-female
#2
Umesh Birole, Ashish Ranade, Mahesh Mone
INTRODUCTION: Tuberculosis is a major health problem worldwide. Extrapulmonary tuberculosis is often secondary to some primary foci in lungs. There are reports of tuberculous osteomyelitis involving maxilla, ulna, femur, and shoulder joint but none have reported pathological fracture in humeral diaphysis due to tuberculosis osteomyelitis without shoulder joint involvement. We report a case of pathological fracture of humerus diaphysis due to tuberculous osteomyelitis with normal articular space...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630238/impact-of-sex-on-cardiac-troponin-concentrations-a-critical-appraisal
#3
REVIEW
Kai M Eggers, Bertil Lindahl
BACKGROUND: The use of sex-specific cutoffs for cardiac troponin (cTn) is currently debated. Although endorsed by scientific working groups, concerns have been raised that sex-specific cutoffs may have only a small clinical effect at the cost of increased complexity in decision-making. METHODS: We reviewed studies investigating the interrelations between high-sensitivity (hs) cTn results and sex, diagnoses, and outcome. Investigated populations included community-dwelling subjects and patients with stable angina, congestive heart failure, or acute chest pain including those with acute coronary syndromes...
June 19, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28628525/assessing-sensitivity-and-specificity-of-the-manchester-triage-system-in-the-evaluation-of-acute-coronary-syndrome-in-adult-patients-in-emergency-care-a-systematic-review
#4
Fernanda Ayache Nishi, Flávia de Oliveira Motta Maia, Itamar de Souza Santos, Dina de Almeida Lopes Monteiro da Cruz
BACKGROUND: Triage is the first assessment and sorting process used to prioritize patients arriving in the emergency department (ED). As a triage tool, the Manchester Triage System (MTS) must have a high sensitivity to minimize the occurrence of under-triage, but must not compromise specificity to avoid the occurrence of overtriage. Sensitivity and specificity of the MTS can be calculated using the frequency of appropriately assigned clinical priority levels for patients presenting to the ED...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28626854/spatial-indices-of-repolarization-correlate-with-non-st-elevation-myocardial-ischemia-in-patients-with-chest-pain
#5
Salah Al-Zaiti, Ervin Sejdić, Jan Nemec, Clifton Callaway, Prem Soman, Robert Lux
Mild-to-moderate ischemia does not result in ST segment elevation on the electrocardiogram (ECG), but rather non-specific changes in the T wave, which are frequently labeled as non-diagnostic for ischemia. Robust methods to quantify such T wave heterogeneity can have immediate clinical applications. We sought to evaluate the effects of spontaneous ischemia on the evolution of spatial T wave changes, based on the eigenvalues of the spatial correlation matrix of the ECG, in patients undergoing nuclear cardiac imaging for evaluating intermittent chest pain...
June 19, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28626633/mediastinal-hemangioendothelioma-case-report-and-review-of-the-literature
#6
Davide Patrini, Laura Scolamiero, Reena Khiroya, David Lawrence, Elaine Borg, Martin Hayward, Nikolaos Panagiotopoulos
BACKGROUND: Epithelioid haemangioendothelioma (EHE) is a rare low-grade vascular neoplasm that can arise in the lung, liver, soft tissues or, less commonly, bone. Due to its low prevalence of less than one in a million and its non-specific clinical features, EHE is often misdiagnosed and managed inappropriately. Here we discuss the case of a 58 year-old gentleman with mediastinal EHE and review existing literature on pulmonary EHE (PEH). CASE HISTORY: A 58 year-old gentleman presented to our outpatient Clinic with chest discomfort and palpitations...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28624401/the-external-validity-of-prediction-models-for-the-diagnosis-of-obstructive-coronary-artery-disease-in-patients-with-stable-chest-pain-insights-from-the-promise-trial
#7
Tessa S S Genders, Adrian Coles, Udo Hoffmann, Manesh R Patel, Daniel B Mark, Kerry L Lee, Ewout W Steyerberg, M G Myriam Hunink, Pamela S Douglas
OBJECTIVES: This study sought to externally validate prediction models for the presence of obstructive coronary artery disease (CAD). BACKGROUND: A better assessment of the probability of CAD may improve the identification of patients who benefit from noninvasive testing. METHODS: Stable chest pain patients from the PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) trial with computed tomography angiography (CTA) or invasive coronary angiography (ICA) were included...
June 9, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28623447/new-approaches-to-gastroesophageal-reflux-disease
#8
William Kethman, Mary Hawn
BACKGROUND: Gastroesophageal reflux disease (GERD) is the most common gastrointestinal disorder of the esophagus. It is a chronic, progressive disorder that presents most typically with heartburn and regurgitation and atypically with chest pain, dysphagia, chronic cough, globus, or sore throat. The mainstay for diagnosis and characterization of the disorder is esophagoduodenoscopy (EGD), high-resolution esophageal manometry, and symptom-associated ambulatory esophageal pH impedance monitoring...
June 16, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28623174/sex-differences-in-the-management-and-5-year-outcome-of-young-patients-55y-with-acute-coronary-syndromes
#9
Avi Sabbag, Shlomi Matetzky, Avital Porter, Zaza Iakobishvili, Mady Moriel, Donna Zwas, Paul Fefer, Elad Asher, Roy Beigel, Shmuel Gottlieb, Ilan Goldenberg, Amit Segev
BACKGROUND: Young women are usually protected against coronary artery disease due to hormonal and risk-factor profile. Previous studies have suggested poorer outcome in women hospitalized with acute coronary syndrome as compared to men. However, when adjusted to age and other risk factors, this difference does not remain significant. We compared the risk-profile and outcome between young (≤55) women and men admitted with acute coronary syndrome. METHODS: We analyzed clinical characteristics, management strategies, and outcomes of men and women ≤55y enrolled in the biennial Acute Coronary Syndrome Israeli Surveys (ACSIS) between 2000 and 2013...
June 13, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28623036/-arrhythmogenic-right-ventricular-cardiomyopathy-dysplasia-literature-review-and-case-report
#10
William Alejandro Camargo-Ariza, Silvia Juliana Galvis-Blanco, Tatiana Del Pilar Camacho-Enciso, Carlos Alberto Quiroz-Romero, Juan José Bermudez-Echeverry
Arrhythmogenic right ventricular cardiomyopathy/dysplasia is an inherited autosomal dominant pathology with an estimated prevalence of 1:2,500 to 1:5,000, being higher in males (3:1). It is characterized histologically by replacement of cardiomyocytes by fibro-adipose tissue, which predisposes to ventricular arrhythmias, right ventricular failure, and sudden cardiac death. The main goal of treatment is to reduce the risk of sudden death and improve the quality of life of patients. We present the case of a 23 year old woman whose clinical symptoms started with palpitations, chest pain with physical activity, syncope and headache 6 years ago during her first pregnancy...
June 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28621042/clinical-evaluation-of-anomalous-aortic-origin-of-a-coronary-artery-aaoca
#11
Silvana Molossi, Hitesh Agrawal
The clinical evaluation of patients with an anomalous aortic origin of a coronary artery (AAOCA), a congenital abnormality of the origin or course of a coronary artery that arises from the aorta, is challenging given its first presentation being sudden cardiac arrest in about half of the patients. Symptoms of chest pain, shortness of breath and syncope during exertion should be of concern in evaluating young athletes and nonathletes. The lack of abnormal signs on the physical exam and electrocardiogram further adds to the difficulty in establishing the diagnosis...
June 16, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28616562/coronary-calcification-compromises-myocardial-perfusion-irrespective-of-luminal-stenosis
#12
Michael Y Henein, Tarek Bengrid, Rachel Nicoll, Ying Zhao, Bengt Johansson, Axel Schmermund
AIM: The aim of this study was to evaluate the relationship between coronary artery calcification (CAC) assessed by multi-detector computed tomography (MDCT) and myocardial perfusion assessed by cardiac magnetic resonance imaging (CMR) in a group of symptomatic patients. METHOD: Retrospective analysis of 120 patients (age 65.1 ± 8.9 years, 88 males) who presented with atypical chest pain to Bethanien Hospital, Frankfurt, Germany, between 2007 and 2010 and who underwent CAC scoring using MDCT, CMR, and conventional coronary angiography...
March 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28616557/dipyridamole-induced-adverse-effects-in-myocardial-perfusion-scans-dynamic-evaluation
#13
Sin-Di Lee, Wei-Chun Huang, Nan-Jing Peng, Chin Hu
AIM AND BACKGROUND: Dipyridamole-induced stress myocardial perfusion scans (MPS) has been widely used for management of coronary artery disease. The adverse effects of dipyridamole and other stress agents have been evaluated. The aim of this research is to confirm the dynamic data on dipyridamole side effects during MPS. METHODS: We collected data of 183 patients who underwent dipyridamole-induced stress MPS by retrospectively reviewing their clinical records, which included the severity of dipyridamole side effects in 3 min, 10 min, and 20 min after infusion...
March 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28616378/primary-ciliary-dyskinesia-presenting-with-spontaneous-pneumothorax-case-report-and-review-of-the-literature
#14
Jia Hou, Yanan Zhang, Ri Gong, Xiwei Zheng, Xia Yang
BACKGROUND: Primary ciliary dyskinesia (PCD) is an autosomal recessive heterogeneous group of conditions with variable clinical findings. CASE PRESENTATION: A 36-year-old nonsmoking Chinese man present to the emergency department of our hospital with acute-onset breathlessness and sudden-onset left-sided chest pain. The patient had 6 years primary infertility and suffered from recurrent episodes of respiratory tract infections since childhood. Chest X-ray was performed, which showed a left-sided pneumothorax with lung collapse...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28614421/zero-calcium-score-as-a-filter-for-further-testing-in-patients-admitted-to-the-coronary-care-unit-with-chest-pain
#15
Luis Cláudio Lemos Correia, Fábio P Esteves, Manuela Carvalhal, Thiago Menezes Barbosa de Souza, Nicole de Sá, Vitor Calixto de Almeida Correia, Felipe Kalil Beirão Alexandre, Fernanda Lopes, Felipe Ferreira, Márcia Noya-Rabelo
Background: The accuracy of zero coronary calcium score as a filter in patients with chest pain has been demonstrated at the emergency room and outpatient clinics, populations with low prevalence of coronary artery disease (CAD). Objective: To test the gatekeeping role of zero calcium score in patients with chest pain admitted to the coronary care unit (CCU), where the pretest probability of CAD is higher than that of other populations. Methods: Patients underwent computed tomography for calcium scoring, and obstructive CAD was defined by a minimum 70% stenosis on invasive angiography...
June 12, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28611898/utility-of-the-history-and-physical-examination-in-the-detection-of-acute-coronary-syndromes-in-emergency-department-patients
#16
REVIEW
Zachary Dw Dezman, Amal Mattu, Richard Body
Chest pain accounts for approximately 6% of all emergency department (ED) visits and is the most common reason for emergency hospital admission. One of the most serious diagnoses emergency physicians must consider is acute coronary syndrome (ACS). This is both common and serious, as ischemic heart disease remains the single biggest cause of death in the western world. The history and physical examination are cornerstones of our diagnostic approach in this patient group. Their importance is emphasized in guidelines, but there is little evidence to support their supposed association...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28611061/clinical-events-and-echocardiographic-lesion-progression-rate-in-subjects-with-mild-or-moderate-aortic-regurgitation
#17
Sveeta Badiani, Jet van Zalen, Saad Saheecha, Lesley Hart, Ann Topham, Nikhil Patel, Lydia Sturridge, Andrew Marshall, Neil Sulke, Stephen Furniss, Guy Lloyd
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)...
June 13, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28610610/atypical-findings-of-perineural-cysts-on-postmyelographic-computed-tomography-a-case-report-of-intermittent-intercostal-neuralgia-caused-by-thoracic-perineural-cysts
#18
Hirokazu Iwamuro, Taro Yanagawa, Sachiko Takamizawa, Makoto Taniguchi
BACKGROUND: Perineural cysts are sometimes found incidentally with magnetic resonance imaging, and clinical symptoms requiring treatment are rare. Perineural cysts typically exhibit delayed filling with contrast medium on myelography, which is one of the criteria used by Tarlov to distinguish perineural cysts from meningeal diverticula. We present a case of multiple thoracolumbar perineural cysts, one of which was considered the cause of intermittent intercostal neuralgia with atypical findings on postmyelographic computed tomography seen as selective filling of contrast medium...
June 13, 2017: BMC Medical Imaging
https://www.readbyqxmd.com/read/28609191/understanding-frequent-emergency-department-use-among-primary-care-patients
#19
Morgan Hardy, Alex Cho, Alissa Stavig, Marigny Bratcher, Janice Dillard, Lawrence Greenblatt, Kevin Schulman
Patients with high emergency department (ED) utilization are an important focus in population health management. This retrospective cohort study analyzed patterns of frequent ED use for 4087 patients enrolled at an academically-affiliated primary care clinic. For all ED visits (n = 4776), the chief complaints, admission rates, number of complaints per patient, and median time between return visits were assessed. Chart reviews were conducted for the 10 highest utilizers from each of the 3 leading complaints to help explain repeated ED use for the same complaints...
June 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28605043/typical-angina-is-associated-with-greater-coronary-endothelial-dysfunction-but-not-abnormal-vasodilatory-reserve
#20
Ahmed AlBadri, Derek Leong, C Noel Bairey Merz, Janet Wei, Eileen M Handberg, Chrisandra L Shufelt, Puja K Mehta, Michael D Nelson, Louise E Thomson, Daniel S Berman, Leslee J Shaw, Galen Cook-Wiens, Carl J Pepine
BACKGROUND: Typical angina (TA) is defined as substernal chest pain precipitated by physical exertion or emotional stress and relieved with rest or nitroglycerin. Women and elderly patients are usually have atypical symptoms both at rest and during stress, often in the setting of nonobstructive coronary artery disease (CAD). HYPOTHESIS: To further understand this, we performed subgroup analysis comparing subjects who presented with TA vs nontypical angina (NTA) using baseline data of patients with nonobstructive CAD and coronary microvascular dysfunction (CMD) enrolled in a clinical trial...
June 12, 2017: Clinical Cardiology
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