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Chest pain assessment clinic

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https://www.readbyqxmd.com/read/29148415/exacerbation-of-beh%C3%A3-et-s-syndrome-and-familial-mediterranean-fever-with-menstruation
#1
Gul Guzelant, Yesim Ozguler, Sinem Nihal Esatoglu, Guzin Karatemiz, Huri Ozdogan, Sebahattin Yurdakul, Hasan Yazici, Emire Seyahi
OBECTIVES: Menstruation triggers several conditions such as migraine, recurrent aphthous stomatitis and acne vulgaris in healthy individuals. There is evidence that Behçet's syndrome (BS) and familial Mediterranean fever (FMF) may exacerbate during menstruation. The aim is to assess whether BS and FMF patients experience menstrual flares. METHODS: Females of reproductive age with BS and FMF seen consecutively at the outpatient clinic of Cerrahpasa Medical Faculty at Istanbul, as well as apparently healthy hospital workers were studied using a standardised questionnaire...
October 24, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29145033/is-chronic-postsurgical-pain-surgery-induced-a-study-of-persistent-postoperative-pain-following-breast-reconstruction
#2
Randy S Roth, Ji Qi, Jennifer B Hamill, Hyungjin M Kim, Tiffany N S Ballard, Andrea L Pusic, Edwin G Wilkins
BACKGROUND: Chronic postsurgical pain (CPSP) is a reported risk for women undergoing breast reconstruction, but it remains unclear that such persistent pain is induced by reconstructive surgery. To address this concern, this prospective cohort study examined the prevalence of and risk factors associated with CPSP among women undergoing breast reconstruction. MATERIALS AND METHODS: Women (n = 1996) recruited for the Mastectomy Reconstruction Outcomes Consortium (MROC) Study were assessed preoperatively and at two-years postoperatively for relevant medical/...
November 13, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29138794/noninvasive-cardiac-testing-vs-clinical-evaluation-alone-in-acute-chest-pain-a-secondary-analysis-of-the-romicat-ii-randomized-clinical-trial
#3
Samuel W Reinhardt, Chien-Jung Lin, Eric Novak, David L Brown
Importance: The incremental benefit of noninvasive testing in addition to clinical evaluation (history, physical examination, an electrocardiogram [ECG], and biomarker assessment) vs clinical evaluation alone for patients who present to the emergency department (ED) with acute chest pain is unknown. Objective: To examine differences in outcomes with clinical evaluation and noninvasive testing (coronary computed tomographic angiography [CCTA] or stress testing) vs clinical evaluation alone...
November 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29138258/challenges-in-delivering-computed-tomography-coronary-angiography-as-the-first-line-test-for-stable-chest-pain
#4
John G Dreisbach, Edward D Nicol, Carl A Roobottom, Simon Padley, Giles Roditi
OBJECTIVE: The National Institute for Health and Care Excellence (NICE) clinical guidelines 'chest pain of recent onset: assessment and diagnosis' (update 2016) state CT coronary angiography (CTCA) should be offered as the first-line investigation for patients with stable chest pain. However, the current provision in the UK is unknown. We aimed to evaluate this and estimate the requirements for full implementation of the guidelines including geographical variation. Ancillary aims included surveying the number of CTCA-capable scanners and accredited practitioners in the UK...
November 14, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29138234/mesalazine-induced-myopericarditis-in-a-patient-with-ulcerative-colitis
#5
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/29132619/a-statistical-analysis-based-recommender-model-for-heart-disease-patients
#6
Anam Mustaqeem, Syed Muhammad Anwar, Abdul Rashid Khan, Muhammad Majid
OBJECTIVES: An intelligent information technology based system could have a positive impact on the life-style of patients suffering from chronic diseases by providing useful health recommendations. In this paper, we have proposed a hybrid model that provides disease prediction and medical recommendations to cardiac patients. The first part aims at implementing a prediction model, that can identify the disease of a patient and classify it into one of the four output classes i.e., non-cardiac chest pain, silent ischemia, angina, and myocardial infarction...
December 2017: International Journal of Medical Informatics
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
#7
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/29121752/identification-of-coronary-artery-calcification-can-optimize-risk-stratification-in-patients-with-acute-chest-pain
#8
Daniel O Bittner, Richard A P Takx, Pedro V Staziaki, Sumbal Janjua, Tomas G Neilan, Nandini M Meyersohn, Michael T Lu, Anand M Prabhakar, John T Nagurney, Udo Hoffmann, Brian B Ghoshhajra
BACKGROUND: The number of patients presenting to the emergency department (ED) with suspected acute coronary syndrome (ACS) is substantial. We tested whether identification of coronary artery calcium (CAC) can improve the negative predictive value (NPV) of clinical risk assessment for ACS in patients with acute chest pain. METHODS AND RESULTS: We included 826 consecutive patients (mean age: 53±11years; 42% female) without known coronary artery disease (CAD) or initially elevated serum biomarkers, whom underwent non-contrast CT, to assess the CAC score, and CT angiography (CTA), to detect coronary stenosis...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29114078/patient-selection-for-high-sensitivity-cardiac-troponin-testing-and-diagnosis-of-myocardial-infarction-prospective-cohort-study
#9
MULTICENTER STUDY
Anoop S V Shah, Yader Sandoval, Ala Noaman, Anne Sexter, Amar Vaswani, Stephen W Smith, Mathew Gibbins, Megan Griffiths, Andrew R Chapman, Fiona E Strachan, Atul Anand, Martin A Denvir, Philip D Adamson, Michelle S D'Souza, Alasdair J Gray, David A McAllister, David E Newby, Fred S Apple, Nicholas L Mills
Objective To evaluate how selection of patients for high sensitivity cardiac troponin testing affects the diagnosis of myocardial infarction across different healthcare settings.Design Prospective study of three independent consecutive patient populations presenting to emergency departments.Setting Secondary and tertiary care hospitals in the United Kingdom and United States.Participants High sensitivity cardiac troponin I concentrations were measured in 8500 consecutive patients presenting to emergency departments: unselected patients in the UK (n=1054) and two selected populations of patients in whom troponin testing was requested by the attending clinician in the UK (n=5815) and the US (n=1631)...
November 7, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29089344/impact-of-diabetes-mellitus-on-the-evaluation-of-stable-chest-pain-patients-insights-from-the-promise-prospective-multicenter-imaging-study-for-evaluation-of-chest-pain-trial
#10
Abhinav Sharma, Nishant K Sekaran, Adrian Coles, Neha J Pagidipati, Udo Hoffmann, Daniel B Mark, Kerry L Lee, Hussein R Al-Khalidi, Michael T Lu, Patricia A Pellikka, Quynh A Trong, Pamela S Douglas
BACKGROUND: The impact of diabetes mellitus on the clinical presentation and noninvasive test (NIT) results among stable outpatients presenting with symptoms suggestive of coronary artery disease (CAD) has not been well described. METHODS AND RESULTS: The PROMISE (Prospective Multicenter Imaging Study for Evaluation of Chest Pain) trial enrolled 10 003 patients with known diabetic status, of whom 8966 were tested as randomized and had interpretable NIT results (1908 with diabetes mellitus, 21%)...
October 31, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29076052/assessment-of-acute-myocarditis-by-cardiac-magnetic-resonance-imaging-comparison-of-qualitative-and-quantitative-analysis-methods
#11
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/29075388/delivery-and-measurement-of-high-value-care-in-standardized-patient-encounters
#12
Jennifer DeLuca Baldwin, Jaclyn Cox, Zhao Helen Wu, Anne Kenny, Steven Angus
BACKGROUND : Residencies have incorporated high-value care (HVC) training to contain health care expenditures. Assessment methods of HVC curricula are limited. OBJECTIVE : In our clinical skills laboratory, we evaluated the effectiveness of HVC curricula using standardized patients (SPs) to determine if there is a correlation with performance in counseling, history and physical, HVC knowledge, and demographics. METHODS : Through ambulatory cases, SPs evaluated postgraduate year 2 (PGY-2) residents using checklists to determine if they obtained the chief complaint, medical and social history, focused physical examination, and conveyed information regarding patient management...
October 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/29063953/magnetic-resonance-myocardial-perfusion-imaging-safety-and-indications-in-pediatrics-and-young-adults
#13
David M Biko, R Thomas Collins, Sara L Partington, Matthew Harris, Kevin K Whitehead, Marc S Keller, Mark A Fogel
The purpose of this study was to assess the safety and indications for cardiac magnetic resonance (CMR) with myocardial perfusion imaging (MPI) in a cohort of children and young adults. A retrospective review of 178 children and young adults who underwent CMR with MPI was performed. Studies were categorized based on study protocols as MPI with resting perfusion only, adenosine stress MPI, exercise-induced stress MPI, and MPI for cardiac mass diagnosis. Relevant clinical history, exam indications, and adverse reactions following gadolinium-based contrast agent and adenosine administration were recorded...
October 24, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29054440/external-validation-of-heart-type-fatty-acid-binding-protein-high-sensitivity-cardiac-troponin-and-electrocardiography-as-rule-out-for-acute-myocardial-infarction
#14
Christopher B Van Hise, Jaimi H Greenslade, William Parsonage, Martin Than, Joanna Young, Louise Cullen
OBJECTIVE: To externally validate a clinical decision rule incorporating heart fatty acid binding protein (h-FABP), high-sensitivity troponin (hs-cTn) and electrocardiogram (ECG) for the detection of acute myocardial infarction (AMI) on presentation to the Emergency Department. We also investigated whether this clinical decision rule improved identification of AMI over algorithms incorporating hs-cTn and ECG only. DESIGN AND METHODS: This study included data from 789 patients from the Brisbane ADAPT cohort and 441 patients from the Christchurch TIMI RCT cohort...
October 18, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/29054304/thoracic-endometriosis-syndrome-other-than-pneumothorax-clinical-and-pathological-findings
#15
Antonio Bobbio, Emeline Canny, Audrey Mansuet Lupo, Filippo Lococo, Antoine Legras, Pierre Magdeleinat, Jean-François Regnard, Anne Gompel, Diane Damotte, Marco Alifano
BACKGROUND: Thoracic endometriosis syndrome refers to a broad spectrum of clinical manifestations related to the presence of ectopic intrathoracic endometrial tissue. Few studies have reported on manifestations other than pneumothorax. METHODS: Clinical, surgical, and pathology records of all consecutive women of reproductive age referred to our institution from September 2001 to August 2016 for clinically suspected thoracic endometriosis syndrome were retrospectively reviewed...
October 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29049223/myocardial-ct-perfusion-imaging-for-pre-and-postoperative-evaluation-of-myocardial-ischemia-in-a-patient-with-myocardial-bridging-a-case-report
#16
Jae Woong Lim, Heon Lee, Keun Her, Hyun Woo Park, Kyung Eun Shin
RATIONALE: Although myocardial bridging (MB) is usually considered as benign, initial medical therapy and following surgical treatment in drug-refractory cases has been widely accepted for managing symptomatic MB. Before the patient proceeds to percutaneous or surgical intervention, however, the presence of objective ischemia in the corresponding myocardial territory should be documented. PATIENT CONCERN AND INTERVENTION: We herein report a 43-year-old male complaining of chest pain in whom cardiac CT with myocardial perfusion (cCTP) showed an MB of left anterior descending artery (LAD) with preoperative perfusion defect in corresponding myocardium and normalization of perfusion after supra-arterial myotomy...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29031990/international-standardization-of-diagnostic-criteria-for-microvascular-angina
#17
Peter Ong, Paolo G Camici, John F Beltrame, Filippo Crea, Hiroaki Shimokawa, Udo Sechtem, Juan Carlos Kaski, C Noel Bairey Merz
Standardization of diagnostic criteria for ischemic symptoms due to coronary microvascular dysfunction (CMD) is needed for further investigation of patients presenting with anginal chest pain consistent with "microvascular angina" (MVA). At the annual Coronary Vasomotion Disorders International Study Group (COVADIS) Summits held in August 2014 and 2015, the following criteria were agreed upon for the investigative diagnosis of microvascular angina: (1) presence of symptoms suggestive of myocardial ischemia; (2) objective documentation of myocardial ischemia, as assessed by currently available techniques; (3) absence of obstructive CAD (<50% coronary diameter reduction and/or fractional flow reserve (FFR) >0...
September 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29030346/diagnostic-accuracy-of-the-aortic-dissection-detection-risk-score-plus-d-dimer-for-acute-aortic-syndromes-the-advised-prospective-multicenter-study
#18
Peiman Nazerian, Christian Mueller, Alexandre de Matos Soeiro, Bernd A Leidel, Sibilla Anna Teresa Salvadeo, Francesca Giachino, Simone Vanni, Karin Grimm, Múcio T Oliveira, Emanuele E Pivetta, Enrico Lupia, Stefano Grifoni, Fulvio Morello
Background -Acute aortic syndromes (AAS) are rare and severe cardiovascular emergencies with unspecific symptoms. For AAS, both misdiagnosis and over-testing are key concerns, and standardized diagnostic strategies may help physicians to balance these risks. D-dimer (DD) is highly sensitive for AAS, but is inadequate as a standalone test. Integration of pre-test probability assessment (PPA) with D-dimer (DD) testing is feasible, but the safety and efficiency of such diagnostic strategy are currently unknown...
October 13, 2017: Circulation
https://www.readbyqxmd.com/read/29029074/multimodality-imaging-evaluation-of-chagas-disease-an-expert-consensus-of-brazilian-cardiovascular-imaging-department-dic-and-the-european-association-of-cardiovascular-imaging-eacvi
#19
Maria Carmo P Nunes, Luigi Paolo Badano, J Antonio Marin-Neto, Thor Edvardsen, Covadonga Fernández-Golfín, Chiara Bucciarelli-Ducci, Bogdan A Popescu, Richard Underwood, Gilbert Habib, Jose Luis Zamorano, Roberto Magalhães Saraiva, Ester Cerdeira Sabino, Fernando A Botoni, Márcia Melo Barbosa, Marcio Vinicius L Barros, Eduardo Falqueto, Marcus Vinicius Simões, André Schmidt, Carlos Eduardo Rochitte, Manoel Otávio Costa Rocha, Antonio Luiz Pinho Ribeiro, Patrizio Lancellotti
Aims: To develop a document by Brazilian Cardiovascular Imaging Department (DIC) and the European Association of Cardiovascular Imaging (EACVI) to review and summarize the most recent evidences about the non-invasive assessment of patients with Chagas disease, with the intent to set up a framework for standardized cardiovascular imaging to assess cardiovascular morphologic and functional disturbances, as well as to guide the subsequent process of clinical decision-making. Methods and results: Chagas disease remains one of the most prevalent infectious diseases in Latin America, and has become a health problem in non-endemic countries...
September 25, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29026414/acute-myocardial-infarction-in-very-young-adults-a-clinical-presentation-risk-factors-hospital-outcome-index-and-their-angiographic-characteristics-in-north-india-amiya-study
#20
Santosh Kumar Sinha, Vinay Krishna, Ramesh Thakur, Ashutosh Kumar, Vikas Mishra, Mukesh Jitendra Jha, Karandeep Singh, Mohit Sachan, Rupesh Sinha, Mohammad Asif, Nasar Afdaali, Chandra Mohan Varma
BACKGROUND: India is currently in the fourth stage of epidemiological transitions where cardiovascular disease is the leading cause of mortality and morbidity. Purpose of the present study was to assess the risk factors, clinical presentation, angiographic profile including severity, and in-hospital outcome of very young adults (aged ≤ 30 years) with first acute myocardial infarction (AMI). METHODS: Total of 1,116 consecutive patients with ST-segment elevation acute myocardial infarction (STEMI) were studied between March 2013 and February 2015 at LPS Institute of Cardiology, Kanpur, Uttar Pradesh, India...
March 2017: ARYA Atherosclerosis
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