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https://www.readbyqxmd.com/read/28210638/an-unusual-suspect-causing-hypoxemic-respiratory-failure
#1
Masooma Aqeel, Bjorn Batdorf, Horatiu Olteanu, Jayshil J Patel
Introduction: Antisynthetase syndrome (ASS) is characterized by the presence of anti-Jo-1 antibodies in conjunction with clinical findings of fever, polymyositis-dermatomyositis, and interstitial lung disease (ILD). Inflammatory myopathies carry a high risk of malignancy, but this association is less well outlined in ASS. We present the case of a patient with ASS who developed non-Hodgkin's lymphoma with acute hypoxemic respiratory failure. Case Presentation: A 44-year-old female with ASS presented with acute hypoxemic respiratory failure...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28207514/arginine-methylation-dysfunction-increased-risk-of-acute-coronary-syndrome-in-coronary-artery-disease-population-a-case-control-study
#2
Shengyu Zhang, Shuyang Zhang, Hongyun Wang, Wei Wu, Yicong Ye
The plasma levels of asymmetric dimethylarginine (ADMA) had been proved to be an independent cardiovascular risk factor. Few studies involved the entire arginine methylation dysfunction. This study was designed to investigate whether arginine methylation dysfunction is associated with acute coronary syndrome risk in coronary artery disease population.In total 298 patients undergoing coronary angiography because of chest pain with the diagnosis of stable angina pectoris or acute coronary syndrome from February 2013 to June 2014 were included...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28198635/impact-of-comorbidities-by-age-on-symptom-presentation-for-suspected-acute-coronary-syndromes-in-the-emergency-department
#3
Larisa A Burke, Anne G Rosenfeld, Mohamud R Daya, Karen M Vuckovic, Jessica K Zegre-Hemsey, Maria Felix Diaz, Josemare Tosta Daiube Santos, Sahereh Mirzaei, Holli A DeVon
BACKGROUND: It is estimated half of acute coronary syndrome (ACS) patients have one or more associated comorbid conditions. AIMS: Aims were to: 1) examine the prevalence of comorbid conditions in patients presenting to the emergency department with symptoms suggestive of ACS; 2) determine if comorbid conditions influence ACS symptoms; and 3) determine if comorbid conditions predict the likelihood of receiving an ACS diagnosis. METHODS: A total of 1064 patients admitted to five emergency departments were enrolled in this prospective study...
February 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28197356/acute-pseudoischemic-ecg-abnormalities-after-right-pneumonectomy
#4
Nada Vasic, Sanja Dimic-Janjic, Ruza Stevic, Branislava Milenkovic, Verica Djukanovic
New onset of electrocardiographic (ECG) abnormalities can occur after lung surgery due to the changes in the position of structures and organs in the chest cavity. The most common heart rhythm disorder is atrial fibrillation. So-called "pseudoischemic" ECG changes that mimic classic ECG signs of acute myocardial ischemia are also often noticed. We report the case of a 68-year-old male, with no prior cardiovascular disease, who underwent extensive surgical resection for lung cancer. On a second postoperative day, clinical and electrocardiographic signs of acute myocardial ischemia occurred...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28197284/st-segment-elevation-myocardial-infarction-door-to-balloon-time-improvement-project
#5
Saad Al Bugami, Jamilah Alrahimi, Abdullah Almalki, Farqad Alamger, Ahmed Krimly, Wail Al Kashkari
BACKGROUND: The purpose of this quality improvement project was to evaluate prospectively the causes of delay for patients with acute ST-segment elevation myocardial infarction (STEMI) requiring primary percutaneous coronary intervention (PCI) upon arrival at the emergency department (ED) and implement recommendations to reduce delays and analyze the impact of recommendations to reduce the door-to-balloon (D2B) time in a newly established cardiac center (King Faisal Cardiac Center (KFCC))...
August 2016: Cardiology Research
https://www.readbyqxmd.com/read/28195938/low-adverse-event-rates-but-high-emergency-department-utilization-in-chest-pain-patients-treated-in-an-emergency-department-observation-unit
#6
Anthony M Napoli, Janette Baird, Steven Tran, Jing Wang
OBJECTIVES: Nearly 40% of all previously admitted chest pain patients re-present to the emergency department (ED) within 1 year regardless of stress testing, and nearly 5% of patients return with a major adverse cardiac event (MACE). The primary objective of this study was to determine the prevalence of return visits to the ED among patients previously admitted to an ED chest pain observation unit (CPU). We also identified the patient characteristics and health risk factors associated with these return ED visits...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28195937/an-updated-protocol-for-evaluating-chest-pain-and-managing-acute-coronary-syndromes
#7
Christopher R Kelly, Ajay J Kirtane, Jennifer Stant, Gregg W Stone, Robert M Minutello, S Chiu Wong, Honeyleen Manuzon, Roxanne Gerow-Smith, Nancy Kelley, LeRoy E Rabbani
Clinical pathways can optimize care both across and within institutions, but regular updates to these pathways based on new clinical trials, professional guidelines, and Food and Drug Administration approvals are essential. Herein we describe the most recent revisions to the New York-Presbyterian Hospital (Columbia University Medical Center and Weill Cornell Medical Center) clinical pathway for acute coronary syndromes and chest pain, which incorporates novel data regarding the timing and administration of P2Y12 inhibition (including the intravenous P2Y12 inhibitor cangrelor) and the appropriateness of prolonged (>1 year) dual antiplatelet therapy for the secondary prevention of ischemic events...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28193103/is-telemetry-monitoring-useful-in-patients-admitted-with-suspected-acute-coronary-syndrome
#8
Jack Perkins, Naveen K Voore, Jaideep Patel, Sathish Sanna, Edana Mann, Sammy Zakaria, Aysegul Gozu
Patients with a chief complaint of chest pain are frequently monitored by telemetry for evaluation of acute coronary syndrome (ACS). However, there is insufficient evidence to support this practice in younger patients without coronary artery disease (CAD). The objective is to assess outcomes of patients younger than 50 years of age and monitored by telemetry. Consecutive medical records of patients admitted for chest pain between January 1, 2009, and June 30, 2010, were reviewed. Patients were excluded who had a CAD history, an abnormal initial troponin, or an abnormal initial electrocardiogram...
February 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28191332/angiotensin-ii-type-1-receptor-gene-a1166c-polymorphism-was-not-associated-with-acute-coronary-syndrome-in-an-iranian-population
#9
Navid Delshad, Majid Ghayour-Mobarhan, Hamed Mirzaei, Kamal Razavi-Azarkhiavi, Mohsen Moohebati, Mitra Hassany, Jamal Kasaian, Mohammad Reza Etemadzadeh, Maryam Sadat Alavi, Javad Behravan
BACKGROUND: There are very limited data for Iranian populations on the predisposing genetic factors for acute coronary syndrome (ACS). OBJECTIVES: The objective of the present study was to investigate the association of the angiotensin II type 1 receptor (AT1R) gene polymorphism and ACS in an Iranian population. PATIENTS AND METHODS: This cross-sectional study was conducted among 263 subjects (97 men and 166 women). Patients (n = 128) aged 30 - 80 years with chest pain were recruited from the emergency department of Ghaem Hospital (Mashhad, Iran)...
November 2016: Iranian Red Crescent Medical Journal
https://www.readbyqxmd.com/read/28185080/wellens-syndrome-can-indicate-high-grade-lad-stenosis-in-case-of-left-bundle-branch-block
#10
Steffen Grautoff
Diagnosing acute myocardial infarction (AMI) in left bundle branch block (LBBB) is challenging. Modified Sgarbossa criteria are known to help detect AMI in LBBB. This is a report about an electrocardiogram (ECG) with Wellens' signs in combination with a pre-existing LBBB. The ECG of a patient with fluctuating chest pain showed very subtle and one day later more obvious Wellens'signs. A left anterior descending artery (LAD) stenosis was diagnosed and successfully treated. Wellens' syndrome can be diagnosed in a case of LBBB and help detect a high-grade LAD stenosis even if modified Sgarbossa criteria are not met...
February 9, 2017: Herzschrittmachertherapie & Elektrophysiologie
https://www.readbyqxmd.com/read/28173744/glutathione-system-participation-in-thoracic-aneurysms-from-patients-with-marfan-syndrome
#11
Alejandra María Zúñiga-Muñoz, Israel Pérez-Torres, Verónica Guarner-Lans, Elías Núñez-Garrido, Rodrigo Velázquez Espejel, Claudia Huesca-Gómez, Ricardo Gamboa-Ávila, María Elena Soto
Aortic dilatation in Marfan syndrome (MFS) is progressive. It is associated with oxidative stress and endothelial dysfunction that contribute to the early acute dissection of the vessel and can result in rupture of the aorta and sudden death. We evaluated the participation of the glutathione (GSH) system, which could be involved in the mechanisms that promote the formation and progression of the aortic aneurysms in MFS patients. Patients and methods: Aortic aneurysm tissue was obtained during chest surgery from eight control subjects and 14 MFS patients...
February 8, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28145667/acute-coronary-syndrome-diagnostic-evaluation
#12
Craig Barstow, Matthew Rice, Jonathan D McDivitt
Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common presentation in patients with MI; however, there are multiple noncardiac causes of chest pain, and the diagnosis cannot always be made based on initial presentation. The assessment of a possible MI includes evaluation of risk factors and presenting signs and symptoms, rapid electrocardiography, and serum cardiac troponin measurements...
February 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28139353/suspected-acs-patients-presenting-with-myocardial-damage-or-a-type-2-myocardial-infarction-have-a-similar-late-mortality-to-patients-with-a-type-1-myocardial-infarction-a-report-from-the-australian-and-new-zealand-2012-snapshot-acs-study
#13
Aisha Etaher, Derek Chew, Julie Redfern, Tom Briffa, Chris Ellis, Christopher Hammett, Jeffrey Lefkovits, John Elliott, Louise Cullen, David Brieger, John K French
BACKGROUND: Cardiac troponin (T and I) are considered the standard markers for detection of myocardial damage and the diagnosis of acute coronary syndrome (ACS) among patients who present to an emergency department with chest pain. However, these markers can be released in other situations and may be associated with short- and long-term clinical outcomes. In this study, we examine late mortality rates among patients presenting with a suspected ACS due to an unstable coronary plaque and those patients having a non-ACS...
December 31, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28134404/-takotsubo-cardiomyopathy-recurrence-in-patient-with-chronic-kidney-disease-case-report-and-literature-review
#14
Francesco Caccetta, Maurizio Caroppo, Fernando Musio, Anna Mudoni, Antonella Accogli, Maria Dolores Zacheo, Domenica Burzo, Rolando Mangia, Michele Accogli, Vitale Nuzzo
Takotsubo cardiomyopathy (CT) is a syndrome characterized by an acute and transient left ventricular dysfunction, electrocardiographic abnormalities suggestive of acute coronary syndrome, chest pain and/or dyspnea, left ventricular mid-apical segments akinesia and normal coronary angiography. It is mainly observed in postmenopausal women after an intense physical or mental stress. The course is usually favourable but sometimes severe complications occur. The recurrence rate is 2-10%. We present the case of a recurrence of CT in a female, 79 years old, with hypertension, diabetes, chronic kidney disease (CKD) stage 3 who was admitted to the emergency room for dyspnea and vomiting...
November 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/28132542/-atypical-complaint-in-myocardial-ischaemia-belching
#15
Nóra Turi-Kováts, Hrisula Arabadzisz, András Zsoldos, János Tomcsányi
While educating non-medical personnel on acute coronary syndrome we often emphasize the importance of early recognition and urgent transfer to acute cardiac center of patients with acute myocardial infarction. Aside from typical symptoms of chest tightness and pain radiating to shoulder, arm and jaw, angina often presents with atypical, non-cardiac complaints. These symptoms, often suggesting gastrointestinal problems, can sometimes mislead even the most experienced physicians. We would like to present the case of an 83-year-old woman with several decades long history of ischaemic heart disease, who recently developed a new anginal symptom: lound, uncontrollable belching...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28129898/-loss-of-capture-by-myocardial-ischemia-a-case-report
#16
A Sonou, P M Adjagba, M Hounkponou, L Codjo, C Houéhanou-Sonou, S Assani, T Yessoufou, J Sacca, M Houénassi
We report the case of a patient with pacemaker who presented chest pain during exercise followed by fainting. He has a history of arterial hypertension and diabetes. The initial examination was normal; the ventricular stimulation threshold was 1.125 volts (V) and cardiac enzymes were normal. Stress test has reproduced chest pain followed by loss of pacemaker capture and asystole. Coronary angiography showed a tight stenosis of the proximal anterior interventricular artery dilated by a drug-eluting stent. The control of stress test was normal...
January 24, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28123553/multiple-pulmonary-emboli-as-a-result-of-renal-cell-carcinoma-a-case-report
#17
Bing Li, Hong Zeng, Mei Ding, Ping Yang, Yuquan He
Pulmonary embolism is the most prevalent and potentially fatal complication of deep vein thrombosis. Renal cell carcinoma (RCC) is occasionally associated with pulmonary embolism, occurring as a result of secondary hypercoagulable states or cancer-associated emboli. The current study describes the case of a 43-year-old male that experienced 'squeezing' pain in the chest, considered to mimic acute coronary syndrome. Following a number of diagnostic examinations, the patient was diagnosed with pulmonary embolism, which led to the detection of RCC...
January 2017: Oncology Letters
https://www.readbyqxmd.com/read/28118300/early-application-of-the-ponseti-casting-technique-for-clubfoot-correction-in-sick-infants-at-the-neonatal-intensive-care-unit
#18
Ehud Lebel, Eliraz Weinberg, Tamar M Berenstein-Weyel, Ruben Bromiker
The treatment of congenital clubfoot has been changing rapidly since the mid-1990s with the worldwide use of the Ponseti method for serial casting and limited operative interventions. This method was first applied for isolated clubfeet and later on for other types of clubfoot (teratologic, residual, and neurogenic). Premature babies sustaining clubfoot commonly suffer from additional congenital and acquired medical problems. These may postpone clubfoot management until urgent issues are resolved. The current study describes early initiation of treatment of clubfoot in premature babies at the neonatal intensive care unit (NICU) and their outcomes...
March 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28117470/pulmonary-function-in-children-and-adolescents-with-sickle-cell-disease-have-we-paid-proper-attention-to-this-problem
#19
Ana Karine Vieira, Cristina Gonçalves Alvim, Maria Cristina Marquez Carneiro, Cássio da Cunha Ibiapina
Objective: To evaluate pulmonary function and functional capacity in children and adolescents with sickle cell disease. Methods: This was a cross-sectional study involving 70 children and adolescents (8-15 years of age) with sickle cell disease who underwent pulmonary function tests (spirometry) and functional capacity testing (six-minute walk test). The results of the pulmonary function tests were compared with variables related to the severity of sickle cell disease and history of asthma and of acute chest syndrome...
November 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28110987/outcomes-for-emergency-department-patients-with-recent-onset-atrial-fibrillation-and-flutter-treated-in-canadian-hospitals
#20
Ian G Stiell, Catherine M Clement, Brian H Rowe, Robert J Brison, D George Wyse, David Birnie, Paul Dorian, Eddy Lang, Jeffrey J Perry, Bjug Borgundvaag, Debra Eagles, Damian Redfearn, Jennifer Brinkhurst, George A Wells
STUDY OBJECTIVE: Recent-onset atrial fibrillation and flutter are the most common arrhythmias managed in the emergency department (ED). We evaluate the management and 30-day outcomes for recent-onset atrial fibrillation and flutter patients in Canadian EDs, where cardioversion is commonly practiced. METHODS: We conducted a prospective cohort study in 6 academic hospital EDs and enrolled patients who had atrial fibrillation and flutter onset within 48 hours. Patients were followed for 30 days by health records review and telephone...
January 19, 2017: Annals of Emergency Medicine
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