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acute chest syndrome

Yasmin Hakim, Anna Forbes, Momina Khan, Benjamin C Whitelaw
Chest pain with elevated serum troponin is a common clinical presentation and is normally managed as suspected myocardial infarction or acute coronary syndrome (ACS). We report a 49 year old man who presented with central chest pain sweating and breathlessness. He had a significantly elevated serum troponin I level and a subsequent angiogram showed near normal coronary arteries. He was subsequently investigated for fever and found to have a 3cm right sided adrenal mass consistent with a pheochromocytoma. After confirmation and appropriate blockade laparoscopic adrenalectomy was performed...
2016: Acute Medicine
William R Fox, Deborah B Diercks
Troponins are proteins commonly found in cardiac tissue that are released during myocardial ischemia or necrosis. These troponins can be detected by assays that can then be used to guide clinical decision-making and disposition, especially if the suspected insult is related to acute coronary syndrome. Timing of troponin measurement can be important as elevations may not be detectible immediately after an insult. New assays have been designed to detect troponin con-centrations previously too low to be detected by conventional assays...
March 2016: Clin Exp Emerg Med
Dario Gulin, Jozica Sikic, Jasna Cerkez Habek, Sandra Jerkovic Gulin, Edvard Galic
Eosinophilic myocarditis (EM) is a rare and potentially fatal disease if left untreated. Because the disease can have a delayed presentation and can appear even after 2 years, its underlying causes often remain unknown. We report the case of a 63-year-old man with an atypical clinical presentation of hypersensitive EM and significant coronary artery disease, which was confirmed through coronary angiography. The patient was treated with hydrochlorothiazide (12.5 mg once daily for 2 years) and budesonide/formoterol (160/4...
December 2016: Drug Saf Case Rep
Christos Panayi, Nagui Antoun, Richard Sandford
A 44-year-old woman with a history of von Hippel-Lindau (VHL) disease, a rare inherited neoplasia syndrome, presented acutely to hospital with a productive cough, symptoms of respiratory tract infection and odynophagia (painful swallowing). A chest X-ray confirmed right-sided pneumonia. Investigation of the persistent odynophagia using barium swallow revealed aspiration of the contrast into the lungs and suggested a neurological cause for her chest infection. Clinical assessment and speech and language therapy confirmed a pseudobulbar palsy...
October 13, 2016: BMJ Case Reports
Shankar Iyer, Subhash Shivtarkar, Ameya Udyavar
Takotsubo cardiomyopathy, also called transient left ventricular apical ballooning syndrome or Gebrochenes-Herz-Syndrome, is a rare entity which may masquerade as acute coronary syndrome (ACS) with sudden onset of chest pain and/or dyspnea, transient left ventricle apical akinesia, electrocardiographic changes typical of ACS and mild increase in cardiac enzymes in the background of normal coronary arteries. Here, we present a case of a 45 year old female who presented with acute onset dyspnea and chest pain with severe ischemic changes on the ECG and raised troponin levels...
April 2016: Journal of the Association of Physicians of India
Giovanni Teruzzi, Giuseppe Calligaris, Paolo Ravagnani, Daniela Trabattoni, Luca Grancini, Giovanni Monizzi, Alessandro Lualdi, Antonio L Bartorelli
Spontaneous coronary artery dissection (SCAD) accounts approximately for 0.2% of cases of acute coronary syndrome. It is defined "spontaneous" in absence of any coronary wall damage. This disease affects primarily young women in good health, with no risk factors for coronary artery disease, especially during the postpartum period. Since the clinical presentation varies widely from no symptoms to typical angina and sudden cardiac death, SCAD incidence is underestimated.A 40-year-old woman, in the 8th week after delivery, was admitted to our emergency department because of acute chest pain, and a diagnosis of inferior and posterior non-ST-elevation myocardial infarction was made...
October 2016: Giornale Italiano di Cardiologia
Anirudh Karanam, S Gurushanthappa
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Rachel A Lindor, Marysia S Tweet, Kiran A Goyal, Christine M Lohse, Rajiv Gulati, Sharonne N Hayes, Annie T Sadosty
BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an infrequently recognized but potentially fatal cause of acute coronary syndrome (ACS) that disproportionately affects women. Little is currently known about how patients with SCAD initially present. OBJECTIVES: We sought to describe patients who presented to the emergency department (ED) with symptoms of SCAD to improve providers' awareness and recognition of this condition. PATIENTS AND METHODS: We performed a retrospective medical record review of all patients who presented to the ED of a single academic medical center from January 1, 2002 through October 31, 2015 and were subsequently diagnosed with SCAD by angiography...
October 8, 2016: Journal of Emergency Medicine
Muhammad Abdul Mabood Khalil, Muhammad Salman Ghazni, Jackson Tan, Nazish Naseer, Muhammad Ashhad Ullah Khalil
Ovarian hyperstimulation syndrome (OHSS) was first described in 1960. It may occur as a complication of gonadotropin hormone therapy during assisted pregnancy or for primary infertility. A 26-year-old female patient with polycystic ovarian syndrome and primary infertility was treated to conceive. She received intravenous gonadotropin-releasing hormone (GnRH) along with follicle-stimulating hormone in an outside private clinic. She presented to the emergency department with abdominal and chest pain, loose stool, vomiting, shortness of breath and decreasing urine output...
May 2016: Case Reports in Gastroenterology
Chung-Lieh Hung, Ding-Kuo Chien, Shou-Chuan Shih, Wen-Han Chang
BACKGROUND: Accurate diagnosis of acute coronary syndrome (ACS) in a timely fashion is challenging in the elderly population, especially elderly women, who usually exhibit atypical clinical symptoms. A multiple cardiac biomarker (MCB) based approach has been shown to improve diagnostic efficacy of ACS. However, data in various age groups and sex differences remain largely unexplored. METHODS: Point-of-care testing (POCT) was performed on 290 patients (aged ≥18 years) who were admitted to the emergency department (ED) with symptoms of acute chest pain under suspicion of acute coronary syndrome (ACS)...
October 7, 2016: BMC Cardiovascular Disorders
Akihiko Kitahara, Seijiro Sato, Terumoto Koike, Masanori Tsuchida
We report here a case of fatal respiratory failure developed during chemotherapy for diffuse large B cell lymphoma that occurred late after lung transplantation. 25-year- old man underwent lung transplantation from brain death donor for respiratory failure due to interstitial pneumonia at the age of 16 years old. Two years after transplantation, his respiratory function decreased gradually. Chronic lung allograft dysfunction including bronchiolitis obliterans( BOS) and restrictive allograft syndrome was suspected and immunosuppression was enhanced...
October 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Neal S Gerstein, Lindsay J Jinkins, Liem C Nguyen, Timothy M Maus, Todd S Dettmer, Lev Deriy
Aortic rupture and transection are constituents of the acute aortic syndrome. Injury to the thoracic aorta during motor vehicle crashes is associated with blunt chest trauma and rapid deceleration mechanisms. Type A dissections and/or rupture of the aorta at the level of the aortic isthmus are the more common presentations of aortic injuries associated with motor vehicle crashes. We present the case of atypical echocardiographic findings of a nearly complete circumferential transection of the proximal ascending aorta injury after a motorcycle crash...
October 4, 2016: Echocardiography
Ankit H Shah, Vivek Bogale, David Hurst, Gregory dePrisco
Acute chest pain is one of the most common reasons for presentation to the emergency department. Although most etiologies of chest pain are easy to clinically ascertain with routine history, physical, and laboratory examinations, we present an important benign cause of acute chest pain that may mimic acute coronary syndrome.
October 2016: Proceedings of the Baylor University Medical Center
Grace Hofmann, Lutana Haan, Jeff Anderson
Esophageal balloons are used in the respiratory monitoring of critical care patients. After the esophageal pressure is measured, the corresponding pleural pressure in the thorax can be projected, enabling lung-thorax compliance to be partitioned into chest-wall compliance and lung compliance. The esophageal balloon allows determination of transpulmonary pressures and a correspondingly individually tailored approach to respiratory care, such as patient-specific titration of positive end-expiratory pressure for patients with extrapulmonary acute respiratory distress syndrome...
October 2016: Critical Care Nurse
O Nallet, N Ketata, N Ferrier, X Marcaggi
Acute chest pain is a common reason of consultation in the emergency department. The difficulty lies in discriminating patients with acute coronary syndrome or other life-threatening conditions from those non-cardiovascular, non-life-threatening chest pain. Only 15 to 25 % of patients with acute chest pain actually have acute coronary syndrome. Algorithms using high sensitivity troponin at admission and a second assessment 1 or 3hours later are validated to "rule in" or "rule out" the diagnosis of non ST-elevation myocardial infarction...
September 29, 2016: Annales de Cardiologie et D'angéiologie
Brit Long, Alex Koyfman
BACKGROUND: Chest pain is a common presentation to the emergency department (ED), though the majority of patients are not diagnosed with acute coronary syndrome (ACS). Many patients are admitted to the hospital due to fear of ACS. OBJECTIVE: Our aim was to investigate controversies in low-risk chest pain evaluation, including risk of missed ACS, stress test, and coronary computed tomography angiography (CCTA). DISCUSSION: Chest pain accounts for 10 million ED visits in the United States annually...
September 29, 2016: Journal of Emergency Medicine
Issam Salouage, Sihem El Aidli, Sarra Kastalli, Riadh Daghfous, Mohamed Lakhal
Anaphylactic reactions are often induced by drugs, and the most frequent ones are penicillin derivates. The concurrence of acute coronary syndrome with hypersensitivity and anaphylactic or anaphylactoid reactions constitutes the Kounis syndrome. We report a case of a coronary stent thrombosis with a fatal outcome complicating an anaphylactic shock induced by amoxicillin-clavulanic acid association. A 58-year-old woman with a history of triple coronary stenting was treated by amoxicillin/clavulanic acid association for pharyngitis...
July 21, 2016: Thérapie
Brit Long, Alex Koyfman
BACKGROUND: Chest pain accounts for 10% of emergency department (ED) visits annually, and many of these patients are admitted because of potentially life-threatening conditions. A substantial percentage of patients with chest pain are at low risk for a major cardiac adverse event (MACE). OBJECTIVE: We investigated controversies in the evaluation of patients with low-risk chest pain, including clinical scores, decision pathways, and shared decision-making. DISCUSSION: ED patients with chest pain who have negative biomarker results and nonischemic electrocardiograms are at low risk for MACE...
September 27, 2016: Journal of Emergency Medicine
Ashish Sharma, Myat Han Soe, Jagdeep Singh, Scott D Newsome
Stiff person syndrome (SPS) is a rare neuroimmunological disorder characterized by severe progressive muscle stiffness in axial and lower extremity musculature with superimposed painful muscle spasms. Although chest pain is a common reason for SPS patients presenting to the emergency room, this disorder is overlooked and not part of the differential diagnosis of chest pain. Herein, we report on a middle age male presenting with classic symptoms of SPS; however, due to the rarity of this disease, he was initially thought to have acute coronary syndrome...
2016: Journal of the National Medical Association
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