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https://www.readbyqxmd.com/read/28100978/inflammation-and-rupture-of-a-congenital-pericardial-cyst-manifesting-itself-as-an-acute-chest-pain-syndrome
#1
Robert A Aertker, Benjamin Y C Cheong, Roberto Lufschanowski
We present the case of a 63-year-old woman with a remote history of supraventricular tachycardia and hyperlipidemia, who presented with recurrent episodes of acute-onset chest pain. An electrocardiogram showed no evidence of acute coronary syndrome. A chest radiograph revealed a prominent right-sided heart border. A suspected congenital pericardial cyst was identified on a computed tomographic chest scan, and stranding was noted around the cyst. The patient was treated with nonsteroidal anti-inflammatory drugs, and the pain initially abated...
December 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28100060/boerhaave-s-syndrome-diagnostic-gastroscopy
#2
Rocío Ferreiro-Iglesias, Manuel Narciso Blanco Freire, Manuel Paz Novo, J Enrique Domínguez Muñoz
A 47-year-old man was attended at the emergency room for severe chest pain after eating sausage with subsequent vomiting and mild upper gastrointestinal bleeding. In the chest radiography we could not see abnormalities. He referred previous episodes of choking without consulting. The urgent gastroscopy detected tertiary contractile activity (nutcracker esophagus) and a foreign body in the lower third of the esophagus. After removing the food bolus, we observed a 4 cm longitudinal tear compatible with esophageal rupture or Boerhaave's syndrome in the right posterior wall of the lower esophagus, proximal to the gastroesophageal junction...
January 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28098116/membranous-glomerulopathy-and-massive-cervical-lymphadenopathy-due-to-immunoglobulin-g4-disease
#3
Kamel El-Reshaid, Shaikha Al-Bader, John Madda
A 32-year-old male presented with acute and severe nephrotic syndrome as well as massive right cervical lymphadenopathy for <2 years. Computed tomography scan of the chest, abdomen, and pelvis did not reveal any lymphadenopathy. Histopathology and immunohistochemical testing of his lymph node biopsy showed infiltrate enriched with immunoglobulin G4 (IgG4)-positive plasma cells. His kidney biopsy showed granular membranous deposits of IgG4 in the basement membrane without interstitial infiltrate. Antiphospholipid 2 receptor antibodies were absent excluding its "idiopathic" nature...
January 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28097791/alpha-thalassaemia-promotes-frequent-vaso-occlusive-crises-in-children-with-sickle-cell-anaemia-through-haemorheological-changes
#4
Céline Renoux, Philippe Connes, Elie Nader, Sarah Skinner, Camille Faes, Marie Petras, Yves Bertrand, Nathalie Garnier, Daniela Cuzzubbo, Lydia Divialle-Doumdo, Kamila Kebaïli, Cécile Renard, Alexandra Gauthier, Maryse Etienne-Julan, Giovanna Cannas, Cyril Martin, Marie-Dominique Hardy-Dessources, Vincent Pialoux, Marc Romana, Philippe Joly
BACKGROUND: Sickle cell anaemia (SCA) is a severe hereditary haemoglobinopathy characterised by haemorheological abnormalities, which play a role in the occurrence of several acute and chronic clinical complications. While β(S) -haplotypes and alpha-thalassaemia modulate SCA clinical severity, their effects on blood rheology have been incompletely described. The aim of this study was to test the effects of these genetic modifiers on the haemorheological properties and clinical complication of children with SCA...
January 18, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28097236/lung-vaso-occlusion-in-sickle-cell-disease-mediated-by-arteriolar-neutrophil-platelet-microemboli
#5
Margaret F Bennewitz, Maritza A Jimenez, Ravi Vats, Egemen Tutuncuoglu, Jude Jonassaint, Gregory J Kato, Mark T Gladwin, Prithu Sundd
In patients with sickle cell disease (SCD), the polymerization of intraerythrocytic hemoglobin S promotes downstream vaso-occlusive events in the microvasculature. While vaso-occlusion is known to occur in the lung, often in the context of systemic vaso-occlusive crisis and the acute chest syndrome, the pathophysiological mechanisms that incite lung injury are unknown. We used intravital microscopy of the lung in transgenic humanized SCD mice to monitor acute vaso-occlusive events following an acute dose of systemic lipopolysaccharide sufficient to trigger events in SCD but not control mice...
January 12, 2017: JCI Insight
https://www.readbyqxmd.com/read/28094851/blood-transfusion-for-preventing-primary-and-secondary-stroke-in-people-with-sickle-cell-disease
#6
REVIEW
Lise J Estcourt, Patricia M Fortin, Sally Hopewell, Marialena Trivella, Winfred C Wang
BACKGROUND: Sickle cell disease is one of the commonest severe monogenic disorders in the world, due to the inheritance of two abnormal haemoglobin (beta globin) genes. Sickle cell disease can cause severe pain, significant end-organ damage, pulmonary complications, and premature death. Stroke affects around 10% of children with sickle cell anaemia (HbSS). Chronic blood transfusions may reduce the risk of vaso-occlusion and stroke by diluting the proportion of sickled cells in the circulation...
January 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#7
Subeer K Wadia, Mark Belkin, Kelsey Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
January 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28091982/death-from-pulmonary-embolism-of-cyanoacrylate-glue-following-gastric-varix-endoscopic-injection
#8
Michael Philip Burke, Chris O'Donnell, Yeliena Baber
We present the case of a 25 year old woman with a complex past medical history including Crigler-Najjar syndrome (Type 1) with a liver transplant in 1993 and subsequent development of cirrhosis with portal hypertension in the transplanted liver. The deceased presented to hospital with hematemesis and investigations showed a large gastric varix. The varix was injected with cyanoacrylate glue. Within 30 min of injection the patient became acutely hypoxic. Urgent chest X-ray demonstrated radio opaque glue within the pulmonary arteries...
January 14, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28077467/gut-microbiota-dependent-trimethylamine-n-oxide-in-acute-coronary-syndromes-a-prognostic-marker-for-incident-cardiovascular-events-beyond-traditional-risk-factors
#9
Xinmin S Li, Slayman Obeid, Roland Klingenberg, Baris Gencer, François Mach, Lorenz Räber, Stephan Windecker, Nicolas Rodondi, David Nanchen, Olivier Muller, Melroy X Miranda, Christian M Matter, Yuping Wu, Lin Li, Zeneng Wang, Hassan S Alamri, Valentin Gogonea, Yoon-Mi Chung, W H Wilson Tang, Stanley L Hazen, Thomas F Lüscher
AIMS: Systemic levels of trimethylamine N-oxide (TMAO), a pro-atherogenic and pro-thrombotic metabolite produced from gut microbiota metabolism of dietary trimethylamine (TMA)-containing nutrients such as choline or carnitine, predict incident cardiovascular event risks in stable primary and secondary prevention subjects. However, the prognostic value of TMAO in the setting of acute coronary syndromes (ACS) remains unknown. METHODS AND RESULTS: We investigated the relationship of TMAO levels with incident cardiovascular risks among sequential patients presenting with ACS in two independent cohorts...
January 11, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28076734/effect-of-a-mass-media-campaign-on-ambulance-use-for-chest-pain
#10
Ziad Nehme, Peter A Cameron, Muhammad Akram, Harry Patsamanis, Janet E Bray, Ian T Meredith, Karen Smith
OBJECTIVES: To evaluate the impact of comprehensive public awareness campaigns by the National Heart Foundation of Australia on emergency medical service (EMS) use by people with chest pain. DESIGN, SETTING AND PARTICIPANTS: A retrospective analysis of 253428 emergency ambulance attendances for non-traumatic chest pain in Melbourne, January 2008 - December 2013. Time series analyses, adjusted for underlying trend and seasonal effects, assessed the impact of mass media campaigns on EMS use...
January 16, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28074704/the-toxicology-of-zinc-chloride-smoke-producing-bombs-and-screens
#11
Ayman El Idrissi, Lisanne van Berkel, Nadia E Bonekamp, Diana J Z Dalemans, Marcel A G van der Heyden
CONTEXT: Zinc chloride (ZnCl2)-based smoke bombs and screens are in use since the Second World War (1939-1945). Many case descriptions on ZnCl2 smoke inhalation incidents appeared since 1945. OBJECTIVE: We provide a comprehensive overview of the clinical symptoms and underlying pathophysiology due to exposure to fumes from ZnCl2 smoke producing bombs. In addition, we give a historical overview of treatment regimens and their outcomes. METHODOLOGY: We performed a literature search on Medline, Scopus and Google Scholar databases using combinations of the following search terms "smoke bomb", "smoke screen", "ZnCl2", "intoxication", "poisoning", "case report", "HE smoke", "hexachloroethane smoke", "smoke inhalation" and "white smoke"...
January 11, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28063854/hospital-admissions-for-chest-pain-associated-with-cocaine-use-in-the-united-states
#12
Vikas Singh, Alex P Rodriguez, Badal Thakkar, Ghamshyambhai R Savani, Nileshkumar J Patel, Apurva O Badheka, Mauricio G Cohen, Carlos E Alfonso, Raul D Mitrani, Juan Viles-Gonzalez, Jeffrey J Goldberger
BACKGROUND: The outcomes related to chest pain associated with cocaine use and its burden on healthcare system are not well studied. METHODS: Data were collected from the Nationwide Inpatient Sample (2001 - 2012). Subjects were identified by using the ICD-9-CM codes. Primary outcome was a composite of mortality, myocardial infarction, stroke and cardiac arrest. RESULTS: We identified 363,143 admissions for cocaine induced chest pain. Mean age was 44...
January 4, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28063812/left-main-occlusion-secondary-to-infective-endocarditis-vegetation-the-unusual-suspect
#13
Marco Pavani, Federico Conrotto, Fabrizio D'Ascenzo, Maurizio D'Amico, Paolo Centofanti, Fiorenzo Gaita
Treatment of acute coronary syndrome secondary to septic coronary embolism during valvular endocarditis is controversial. Urgent coronary angiography and stent implantation or surgical intervention have been proposed. We present the case of a patient presented at the emergency department with chest pain and cardiogenic shock. The coronary angiography showed a large filling defect in the left main due to a septic coronary embolism.
November 30, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28062616/early-rule-out-and-rule-in-strategies-for-myocardial-infarction
#14
REVIEW
Louise A Cullen, Nicholas L Mills, Simon Mahler, Richard Body
BACKGROUND: Patients with chest pain comprise a large proportion of emergency presentations and place a major burden on healthcare resources. Therefore, efforts to safely and rapidly identify those with and without acute myocardial infarction (AMI) are needed. The challenge for clinicians is to accurately identify patients with acute coronary syndromes, while balancing the need to safely and rapidly reassure and discharge those without serious conditions. CONTENT: This review summarizes the evidence to date on optimum accelerated strategies for the rule-in and rule-out of AMI, using strategies focused on optimum use of troponin results...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28060121/the-sickle-%C3%AE-thalassemia-phenotype
#15
Adekunle D Adekile, Nagihan Akbulut, Asmaa F Azab, Sundus Al-Sharida, Diana Thomas
Sβ-thalassemia (Sβ-thal) is common among Gulf Arab patients with sickle cell disease, but the phenotype of this group had not been well-documented. We have studied a group of Kuwaiti patients and compared the phenotype in the homozygotes (SS) and Sβ-thal patients. Complete blood count, hemoglobin quantitation, serum bilirubin, and lactate dehydrogenase were determined with standard techniques. The patients were screened for α-globin genotype. The Sβ-thal patients were also screened for the HBG2 Xmn-1 polymorphism...
January 5, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28055270/takotsubo-cardiomyopathy-a-known-unknown-foe-of-asthma
#16
Ourania S Kotsiou, Alexandros Douras, Demosthenes Makris, Nikoleta Mpaka, Konstantinos I Gourgoulianis
INTRODUCTION: Patients with uncontrolled asthma are at a greater risk of asthma attacks requiring emergency room visits or hospital admissions. Takotsubo cardiomyopathy is potentially a significant complication in a course of status asthmaticus. CASE STUDY: We present a 43-year-old female patient who presented with status asthmaticus further complicated with takotsubo cardiomyopathy. RESULTS: Recognizing apical ballooning syndrome is challenging in patients with a history of respiratory disease because the symptoms of the last entity may complicate the diagnostic approach...
January 5, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28054136/-role-of-imaging-procedures-in-clarification-of-complications-of-pneumonia
#17
K Lampichler
CLINICAL ISSUE: Despite a considerable number of antimicrobial agents and interdisciplinary treatment options, lower respiratory tract infections are still associated with high morbidity and mortality rates. Infections of the respiratory tract can lead to severe complications, such as empyema, lung abscesses and acute respiratory distress syndrome (ARDS). Besides intrapulmonary complications pneumonia can also impair other organs due to a systemic inflammatory response. Underlying cardiovascular diseases, such as chronic heart failure, arteriosclerosis and dysrhythmia can either deteriorate due to infections or be newly manifested as a result of pneumonia...
January 2017: Der Radiologe
https://www.readbyqxmd.com/read/28051221/contribution-of-cardiac-magnetic-resonance-imaging-in-the-diagnosis-of-acute-coronary-syndrome-with-normal-coronary-angiography
#18
Rana Dahmani, Rim Ben Said, Younes Arous, Houaida Mahfoudhi, Chedia Chourabi, Mehdi Ghommidh, Badii Jedaida, Nizar Ben Mansour, Abdeddayem Haggui, Nadhem Hajlaoui, Dhaker Lahidheb, Wafa Fehri, Habib Haouala
Background - Acute coronary syndrome with high level of troponin is a common pattern for emergency consultation. In 10% of cases, coronary angiography concluded that there were no significant coronary lesions. The contribution of cardiac magnetic resonance imaging (MRI) in the etiological investigation is increasing in these conditions. Aim - We analyzed the diagnostic value of cardiac MRI in case of acute coronary syndromes with elevated troponin and normal coronary angiography. Methods - It's a retrospective analytical study including 31 patients presenting with acute coronary syndrome with positive troponins and normal coronary angiography...
June 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28038722/management-standards-for-stable-coronary-artery-disease-in-india
#19
Sundeep Mishra, Saumitra Ray, Jamshed J Dalal, J P S Sawhney, S Ramakrishnan, Tiny Nair, S S Iyengar, V K Bahl
Coronary artery disease (CAD) is one of the important causes of cardiovascular morbidity and mortality globally, giving rise to more than 7 million deaths annually. An increasing burden of CAD in India is a major cause of concern with angina being the leading manifestation. Stable coronary artery disease (SCAD) is characterised by episodes of transient central chest pain (angina pectoris), often triggered by exercise, emotion or other forms of stress, generally triggered by a reversible mismatch between myocardial oxygen demand and supply resulting in myocardial ischemia or hypoxia...
December 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/28029000/comparison-between-soluble-st2-and-high-sensitivity-troponin-i-in-predicting-short-term-mortality-for-patients-presenting-to-the-emergency-department-with-chest-pain
#20
Rossella Marino, Laura Magrini, Francesca Orsini, Veronica Russo, Patrizia Cardelli, Gerardo Salerno, Mina Hur, Salvatore Di Somma
BACKGROUND: High-sensitivity cardiac troponin I (hs-cTnI) and the soluble isoform of suppression of tumorigenicity 2 (sST2) are useful prognostic biomarkers in acute coronary syndrome (ACS). The aim of this study was to test the short term prognostic value of sST2 compared with hs-cTnI in patients with chest pain. METHODS: Assays for hs-cTnI and sST2 were performed in 157 patients admitted to the Emergency Department (ED) for chest pain at arrival. In-hospital and 30-day follow-up mortalities were assessed...
March 2017: Annals of Laboratory Medicine
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