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https://www.readbyqxmd.com/read/29780643/late-diagnosis-of-anomalous-aortic-origin-of-a-coronary-artery-from-the-inappropriate-sinus-of-valsalva-during-investigation-of-chest-pain
#1
Brunna Priscylla Américo Carvalho, Marcio Antônio Dos Santos, Wilson Pedro Guimarães Neto, Júlio César Queiroz De França, Márcio Rogério de Souza Braite, Rodrigo Bottura De Araújo, Isabella Gomes Carvalho, Moacir Fernandes de Godoy
In this work are reported two cases of anomalous aortic origin of a coronary artery (AAOCA), with the left main coronary artery (LMCA) arising at the right sinus of Valsalva in a 77-year-old woman and in a 79-year-old man submitted to angiography after positive ischemic tests. The origin of the LMCA or the left descendant artery (LDA) from the right sinus of Valsalva has a prevalence of 0.2%, the origin of the circumflex artery (CXA) from the right sinus 0.5%, and the origin of the right coronary artery (RCA) from the left sinus of Valsalva has a prevalence of 0...
2018: Case Reports in Cardiology
https://www.readbyqxmd.com/read/29778312/biomarker-signatures-of-sickle-cell-disease-severity
#2
Mengtian Du, Sarah Van Ness, Victor Gordeuk, Sayed M Nouraie, Sergei Nekhai, Mark Gladwin, Martin H Steinberg, Paola Sebastiani
Identifying sickle cell disease patients at high risk of complications could lead to personalized treatment and better prognosis but despite many advances prediction of the clinical course of these patients remains elusive. We propose a system-type approach to discover profiles of multiple, common biomarkers that correlate with morbidity and mortality in sickle cell disease. We used cluster analysis to discover 17 signatures of 17 common circulating biomarkers in 2320 participants of the Cooperative Study of Sickle Cell Disease, and evaluated the association of these signatures with risk for stroke, pain, leg ulceration, acute chest syndrome, avascular necrosis, seizure, death, and trend of fetal hemoglobin and hemolysis using longitudinally collected data...
May 16, 2018: Blood Cells, Molecules & Diseases
https://www.readbyqxmd.com/read/29776959/symptom-burden-of-atrial-fibrillation-and-its-relation-to-interventions-and-outcome-in-europe
#3
Renate B Schnabel, Ladislav Pecen, Nargiz Rzayeva, Markus Lucerna, Yanish Purmah, Francisco M Ojeda, Raffaele De Caterina, Paulus Kirchhof
BACKGROUND: Little is known about the association of atrial fibrillation symptom burden with quality of life and outcomes. METHODS AND RESULTS: In the Prevention of Thromboembolic Events-European Registry in Atrial Fibrillation (n=6196 patients with atrial fibrillation; mean±SD age, 71.8±10.4 years; 39.7% women), we assessed European Heart Rhythm Association score symptoms and calculated correlations with the standardized health status questionnaire (EQ-5D-5L)...
May 18, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29776942/postpartum-pneumomediastinum-and-subcutaneous-emphysema
#4
Diaeddin Sagar, Trevor K Rogers, Aldrin Adeni
We present the case of a 22-year-old primigravida with symptoms of neck swelling and difficulty breathing 3 hours after uneventful vaginal delivery. On examination, there was surgical emphysema. A CT scan confirmed air in the subcutaneous tissues and also revealed pneumomediastinum. There was no evidence of pneumothorax and gastro-oesophageal endoscopy showed no signs of oesophageal rupture. The patient remained clinically stable throughout her admission and was discharged home after 48 hours of observation...
May 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29773479/emergency-department-diagnosis-of-septic-pulmonary-embolism-due-to-infectious-endocarditis-using-bedside-ultrasound
#5
Jason Arthur, Juvenal Havyarimana, Ashley Booth Norse
BACKGROUND: Septic pulmonary embolism (SPE) is a rare disorder caused by metastasis of infectious thrombi to the lungs. Most commonly, this occurs as a result of infectious endocarditis. This clinical entity may easily be confused for more common and less mortal diagnoses such as pneumonia, bronchitis, or pulmonary embolism. CASE REPORT: A 47-year-old woman presented in respiratory distress with a complaint of cough productive of rusty sputum, shortness of breath, and pleuritic chest pain...
May 14, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29771705/the-causality-nexus-between-the-tako-tsubo-syndrome-and-an-assault-a-forensic-case-report
#6
Malek Zribi, Syrine Azza Manoubi, Narjes Karray, Salma Charfeddine, Wiem Benamar, Zouhir Hammami, Samir Kammoun, Samir Maatoug
"Tako-tsubo" cardiomyopathy, also known as "broken heart syndrome," is one of the rarest types of stress-induced cardiomyopathy. It frequently mimics acute coronary syndrome, characterized by transient left ventricular dysfunction, electrocardiographic changes, and release of myocardial enzymes. After treatment, the patients are cured in most cases without sequelae. Tako-tsubo syndrome is rarely considered as a reason for consultation in the forensic department.Herein, we report a case of a 68-year-old woman who was assaulted by her police officer neighbor...
May 4, 2018: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/29769019/comparison-of-outcomes-in-emergency-department-patients-with-suspected-cardiac-chest-pain-two-centre-prospective-observational-study-in-southern-china
#7
Huilin Jiang, Yunmei Li, Junrong Mo, Xiaohui Chen, Min Li, Peiyi Lin, Kevin K C Hung, Timothy H Rainer, Colin A Graham
BACKGROUND: Hong Kong (HK) and Guangzhou (GZ) are cities in China with different healthcare systems. This study aimed to compare 30-day and 6-month mortality and characteristics of patients with suspected cardiac chest pain admitted to two emergency departments (ED) in HK and GZ. METHODS: A prospective observational study enrolled patients with suspected cardiac chest pain presenting to EDs in the Prince of Wales Hospital (PWH), HK and the Second Affiliated Hospital of Guangzhou Medical University (AHGZMU),GZ...
May 16, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29768378/cerebral-infarction-as-initial-presentation-in-stress-cardiomyopathy-case-report-and-literature-review
#8
Qiongying Wang, Heng Yu, Cheng Jiang, Runmin Sun, Miaomiao Qi, Shougang Sun, Guangli Xu, Hongbin Cai, Zhenchang Zhang, Feng Zhao, Xiaoqing Kou, Jing Yu, Feng Bai
RATIONALE: The typical symptoms of stress cardiomyopathy include sudden-onset chest pain and breathlessness or collapse as well as classical symptoms of cardiovascular disease; however, rare reports have described nervous system symptoms as the initial manifestation. Here, we report the case of a young man who presented with a large cerebral infarction as the main clinical symptom of stress cardiomyopathy to increase recognition of the disease. PATIENT CONCERNS: A 28-year-old man was admitted to our hospital for sudden-onset weakness of the right limbs and unconsciousness for 1 day...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29768320/monocyte-chemoattractant-protein-1-as-a-predictor-of-coronary-atherosclerosis-in-patients-receiving-coronary-angiography
#9
Simon A Mahler, Thomas C Register, Robert F Riley, Ralph B D'Agostino, Jason P Stopyra, Chadwick D Miller
BACKGROUND: Animal studies suggest that monocyte chemoattractant protein-1 (MCP-1) is a promising biomarker for coronary artery atherosclerosis (CAA), but human studies have been inconclusive. OBJECTIVE: To determine potential relationships between plasma MCP-1 and CAA in patients with acute chest pain. METHODS: A secondary analysis of 150 patients enrolled in emergency department chest pain risk stratification clinical investigations was conducted...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29766301/randomized-clinical-trial-comparing-laparoscopic-hiatal-hernia-repair-using-sutures-versus-sutures-reinforced-with-non-absorbable-mesh
#10
Jelmer E Oor, David J Roks, Jan H Koetje, Joris A Broeders, Henderik L van Westreenen, Vincent B Nieuwenhuijs, Eric J Hazebroek
BACKGROUND: Current literature is characterized by a discrepancy between reported symptomatic and radiological recurrent hiatal hernia's following primary repair. Crural augmentation using mesh is suggested to reduce recurrence rates. The aim of this trial is to analyze 1-year outcome of laparoscopic hiatal hernia repair using sutures versus sutures reinforced with non-absorbable mesh. METHODS: Between 2013 and 2016, 72 patients with an objectified hiatal hernia were randomized for primary repair using non-absorbable sutures and sutures reinforced with non-absorbable mesh...
May 15, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29765785/spondylocostal-dysostosis-a-literature-review-and-case-report-with-long-term-follow-up-of-a-conservatively-managed-patient
#11
Brendan R Southam, Adam P Schumaier, Alvin H Crawford
Introduction: Patients with spondylocostal dysostosis (SCD) have congenital spine and rib deformities associated with frequently severe thoracic insufficiency and respiratory compromise. The literature is largely composed of case reports and small cohorts, and there is little information regarding adults with this condition. In this report, we describe the natural history of a conservatively treated patient and include quality-of-life issues such as childbearing, athletic participation, and occupational selection...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29756723/-pleuropulmonary-blastoma-case-report
#12
Jenny C Salazar, Manuel Pardo, Víctor M Mora-Bautista
Pleuropulmonary Blastoma corresponds to a malignant primary lung disorder, exclusive of pediatric age, infrequent and of aggressive characteristics. Age on diagnosis is 1 month-12 years. Rates per sex are equal. It can be found inside pleura or lungs. Respiratory distress associated or not with pneumothorax, chest pain and fever are classical clinical signs. These symptoms could be misdiagnosed as pneumonia. Radiologically, a large mass near the pleura at the base of the right lung without air bronchogram is its most common form...
June 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29756524/chest-pain-atherosclerotic-cardiovascular-disease-risk-and-cardiology-referral-in-primary-care
#13
Vishaal Buch, Hayley Ralph, Joanne Salas, Paul J Hauptman, Dawn Davis, Jeffrey F Scherrer
BACKGROUND: The atherosclerotic cardiovascular disease (ASCVD) 10-year risk estimate is recommended by cardiologists for determining risk of a cardiac event. However, the majority of patients presenting to primary care with chest pain have noncardiac etiologies. Therefore, we determined if high versus low ASCVD risk was associated with primary care physicians' referral to cardiology in patients with and without chest pain. METHODS: Deidentified electronic health record (EHR) data was obtained from 5795 patients treated in academic primary care clinics from 2008 to 2015...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29754134/surprising-pathological-and-clinical-manifestations-of-miliary-tuberculosis
#14
Kamonkiat Wirunsawanya, Dennis Thomas Bolger
We report a surprising pathological finding of miliary tuberculosis (TB) in a 49-year-old Chuukese, immunocompetent woman who was initially admitted to the hospital for a 1-month duration of chronic abdominal pain and intermittent fevers. Her clinical symptoms did not improve despite treatment with vancomycin and piperacillin-tazobactam. Based on the primary abdominal CT findings suggesting advanced ovarian cancer with omental metastatic disease, further workup with omental core biopsy was performed and demonstrated acute neutrophilic necrosis without malignant cells or granulomata...
May 12, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29751199/intrapericardial-gossypiboma-rare-cause-of-intrathoracic-mass
#15
Anil Kumar, Shiv Shankar Paswan, Rajinder Prashad, Rekha Kumari, Bindey Kumar
INTRODUCTION: Gossypiboma is a retained surgical sponge inside our body after surgical intervention. It is most commonly found in abdominal cavity. Its occurrence in thoracic cavity as intrapericardial gossypiboma is extremely rare. PRESENTATION OF CASE: We present a 25 year old male with complaint of chest pain for 1 year. He had a history of total correction of Tetralogy of fallot 14 years back, at another hospital. On clinical examination and investigations including contrast enhanced computed tomography (CECT) of thorax; diagnosis of right anterior mediastinal mass of germ cell tumor was made and planned for thoracotomy...
May 3, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29749756/sensitivity-and-specificity-of-the-manchester-triage-system-in-risk-prioritization-of-patients-with-acute-myocardial-infarction-who-present-with-chest-pain
#16
Fernanda A Nishi, Catarina Polak, Diná de Almeida Lopes Monteiro da Cruz
BACKGROUND: The purpose of the Manchester Triage System is to clinically prioritize each patient seeking care in an emergency department. Patients with suspected acute myocardial infarction who have typical symptoms including chest pain should be classified in the highest priority groups, requiring immediate medical assistance or care within 10 min. As such, the Manchester Triage System should present adequate sensitivity and specificity. AIMS: This study estimated the sensitivity and specificity of the Manchester Triage System in the triage of patients with chest pain related to the diagnosis of acute myocardial infarction, and the associations between the performance of the Manchester Triage System and selected variables...
May 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29748750/clinical-and-laboratory-features-of-children-with-community-acquired-pneumonia-are-associated-with-distinct-radiographic-presentations
#17
Oana G Falup-Pecurariu, Javier Diez-Domingo, Susanna Esposito, Adam Finn, Fernanda Rodrigues, Vana Spoulou, George A Syrogiannopoulos, Vytautas Usonis, David Greenberg
Chest radiographs from children with community-acquired pneumonia (CAP) were categorized into three distinct presentations and each presentation was correlated to clinical and laboratory findings. Children < 59 months with CAP presenting to pediatric emergency rooms during two years were enrolled prospectively in eight centers across Europe. Clinical and laboratory data were documented and radiographs obtained from patients. Of the 1107 enrolled patients, radiographs were characterized as 74.9% alveolar CAP, 8...
May 11, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29748527/extreme-right-axis-deviation-in-acute-myocardial-infarction-a-hazardous-signal-of-poor-prognosis
#18
Qingyu Wang, Shuo Pan, Fuqiang Liu, Dan Yang, Jun-Kui Wang
BACKGROUND New-onset extreme right axis deviation and right bundle branch block (RBBB) are rare during acute myocardial infarction (AMI), and has only been reported in several cases reflecting the severity of AMI. It could predict severe clinical complications and higher risks in coronary artery disease. Although there is little electrophysiological explanation, the complications are severe. They should be emphasized in newly diagnosed extreme right axis deviation and RBBB in AMI. CASE REPORT A 72-year-old male was admitted to our department with a chief complaint of intermittent retrosternal chest pain and was diagnosed with extensive anterior myocardial infarction with RBBB, by elevated myocardial enzymes and ECG...
May 11, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29743472/a-case-of-perforated-jejunal-diverticulum-an-unexpected-cause-of-pneumoperitoneum-in-a-patient-presenting-with-an-acute-abdomen
#19
Bruno Augusto Alves Martins, Rosana Rodrigues Galletti, Júlio Marinho Dos Santos Neto, Caroline Neiva Mendes
BACKGROUND Jejunal diverticulosis is a rare clinical condition, and the majority of patients are asymptomatic. However, some patients can develop serious complications, including perforation. We report the case of a 74-year-old female patient with a perforated jejunal diverticulum who presented with an 'acute abdomen' and with pneumoperitoneum on X-ray radiography. CASE REPORT A 74-year-old female patient presented to the emergency department with a 24-hour history of acute onset of diffuse abdominal pain associated with nausea and vomiting...
May 10, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29742716/symptom-clusters-and-treatment-time-delay-in-korean-patients-with-st-elevation-myocardial-infarction-on-admission
#20
Hee-Sook Kim, Sang Jun Eun, Jin Yong Hwang, Kun-Sei Lee, Sung-Il Cho
Most patients with acute myocardial infarction (AMI) experience more than one symptom at onset. Although symptoms are an important early indicator, patients and physicians may have difficulty interpreting symptoms and detecting AMI at an early stage. This study aimed to identify symptom clusters among Korean patients with ST-elevation myocardial infarction (STEMI), to examine the relationship between symptom clusters and patient-related variables, and to investigate the influence of symptom clusters on treatment time delay (decision time [DT], onset-to-balloon time [OTB])...
May 2018: Medicine (Baltimore)
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