Read by QxMD icon Read

vancouver chest pain

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
Marcus Eng Hock Ong, Ying Hao, Susan Yap, Pin Pin Pek, Terrance Siang Jin Chua, Faith Suan Peng Ng, Swee Han Lim
OBJECTIVES: The new Vancouver Chest Pain (VCP) Rule recommends early discharge for chest pain patients who are at low risk of developing acute coronary syndrome (ACS), and thus can be discharged within 2 hours of arrival at the emergency department (ED). This study aimed to assess the performance of the new VCP Rule for Asian patients presenting with chest pain at the ED. METHODS: This prospective cohort study involved patients attended to at the ED of a large urban centre...
July 27, 2016: CJEM
Dylan Flaws, Martin Than, Frank Xavier Scheuermeyer, James Christenson, Barbara Boychuk, Jaimi H Greenslade, Sally Aldous, Christopher J Hammett, William A Parsonage, Joanne M Deely, John W Pickering, Louise Cullen
OBJECTIVE: The emergency department assessment of chest pain score accelerated diagnostic pathway (EDACS-ADP) facilitates low-risk ED chest pain patients early to outpatient investigation. We aimed to validate this rule in a North American population. METHODS: We performed a retrospective validation of the EDACS-ADP using 763 chest pain patients who presented to St Paul's Hospital, Vancouver, Canada, between June 2000 and January 2003. Patients were classified as low risk if they had an EDACS <16, no new ischaemia on ECG and non-elevated serial 0-hour and 2-hour cardiac troponin concentrations...
September 2016: Emergency Medicine Journal: EMJ
Annie Y Chou, Roshan Prakash, Jennifer Rajala, Taira Birnie, Saul Isserow, Carolyn M Taylor, Andrew Ignaszewski, Sammy Chan, Andrew Starovoytov, Jacqueline Saw
BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an important cause of myocardial infarction in women, but the role of rehabilitation after SCAD is unclear. METHODS: We designed a dedicated SCAD cardiac rehabilitation (SCAD-CR) program for our SCAD survivors at Vancouver General Hospital. This program encompasses a multidisciplinary approach including exercise rehabilitation, psychosocial counselling, dietary and cardiovascular disease education, and peer group support...
April 2016: Canadian Journal of Cardiology
Edward W Carlton, Ahmed Khattab, Kim Greaves
STUDY OBJECTIVE: We compare the ability of 5 established risk scores to identify patients with suspected acute coronary syndromes who are suitable for discharge after a modified single-presentation high-sensitivity troponin result. METHODS: This was a prospective observational study conducted in a UK district general hospital emergency department. Consecutive adults recruited with suspected acute coronary syndrome for whom attending physicians determined evaluation with serial troponin testing was required...
December 2015: Annals of Emergency Medicine
Hyung Chae Yang, Hyong-Ho Cho, Si Young Jo, Chul Ho Jang, Yong Beom Cho
OBJECTIVES: Autologous costal cartilage is a promising alternative for mastoid obliteration. However, donor-site morbidities of the chest wall limit the use of this graft. To address this issue, we have developed a minimally-invasive technique of harvesting costal cartilage and report donor site morbidity associated with the procedure. METHODS: Donor site morbidities were evaluated for 151 patients who underwent costal cartilage harvest, canal wall down mastoidectomy, and mastoid obliteration...
March 2015: Clinical and Experimental Otorhinolaryngology
Frank Xavier Scheuermeyer, Hubert Wong, Eugenia Yu, Barb Boychuk, Grant Innes, Eric Grafstein, Kenneth Gin, Jim Christenson
OBJECTIVES: Current guidelines emphasize that emergency department (ED) patients at low risk for potential ischemic chest pain cannot be discharged without extensive investigations or hospitalization to minimize the risk of missing acute coronary syndrome (ACS). We sought to derive and validate a prediction rule that permitted 20 to 30% of ED patients without ACS safely to be discharged within 2 hours without further provocative cardiac testing. METHODS: This prospective cohort study enrolled 1,669 chest pain patients in two blocks in 2000-2003 (development cohort) and 2006 (validation cohort)...
March 2014: CJEM
Louise Cullen, Jaimi H Greenslade, Martin Than, Anthony F T Brown, Christopher J Hammett, Arvin Lamanna, Dylan F Flaws, Kevin Chu, Lindsay F Fowles, William A Parsonage
OBJECTIVES: To externally evaluate the accuracy of the new Vancouver Chest Pain Rule and to assess the diagnostic accuracy using either sensitive or highly sensitive troponin assays. METHODS: Prospectively collected data from 2 emergency departments (EDs) in Australia and New Zealand were analysed. Based on the new Vancouver Chest Pain Rule, low-risk patients were identified using electrocardiogram results, cardiac history, nitrate use, age, pain characteristics and troponin results at 2 hours after presentation...
February 2014: American Journal of Emergency Medicine
Jaimi H Greenslade, Louise Cullen, Martin Than, Sally Aldous, Kevin Chu, Anthony F T Brown, A Mark Richards, Christopher J Pemberton, Peter George, William A Parsonage
OBJECTIVES: The objective of this study is to evaluate the accuracy of the Vancouver Chest Pain Rule using troponin as the only biomarker in an emergency department (ED) setting. METHODS: This is an analysis of prospectively collected data from 2 EDs in Australia and New Zealand. Trained research nurses collected clinical data using a customised case report form. Based on a modified Vancouver Chest Pain Rule using troponin as the only biomarker, low-risk patients were identified using clinical history, age, pain characteristics, electrocardiography, and troponin results at 0 and 2 hours after presentation...
July 2013: American Journal of Emergency Medicine
Mohammad Jalili, Zia Hejripour, Amir Reza Honarmand, Nasim Pourtabatabaei
OBJECTIVES: The objective was to validate the Vancouver Chest Pain Rule in an emergency department (ED) setting to identify very-low-risk patients with acute chest pain. METHODS: A prospective cohort study was conducted on consecutive patients 25 years of age and older presenting to the ED with a chief complaint of acute chest pain during January 2009 to July 2009. According to the Vancouver Chest Pain Rule, cardiac history, chest pain characteristics, physical and electrocardiogram (ECG) findings, and cardiac biomarker measurement (creatine kinase-myocardial band isoenzyme [CK-MB]) were used to identify patients with very low risk for developing acute coronary syndrome (ACS) in 30 days...
July 2012: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Sonia Singh, Bohdan Nosyk, Huiying Sun, James Malcolm Christenson, Grant Innes, Aslam Hayat Anis
OBJECTIVES: The aim of this study was to estimate the potential cost-effectiveness and expected value of perfect information of a recently derived clinical prediction rule for patients presenting to emergency departments with chest discomfort. METHODS: A decision analytic model was constructed to compare the Early Disposition Prediction Rule (EDPR) with the current standard of care. Results were used to calculate the potential cost-effectiveness of the EDPR, as well as the Value of Information in conducting further research...
2008: International Journal of Technology Assessment in Health Care
Pamela A Ratner, Roula Tzianetas, Andrew W Tu, Joy L Johnson, Martha Mackay, Christopher E Buller, Maureen Rowlands, Birgit Reime
STUDY OBJECTIVE: To find out if gender and ethnicity are associated with acute myocardial infarction (AMI) symptom recognition and the recommendation of enlisting emergency medical services. DESIGN: In an experiment, a random sample of the public was provided a scenario of a person experiencing symptoms of AMI; the gender of the character (male, female, or indeterminate) was manipulated. SETTING: Vancouver, Canada PARTICIPANTS: 976 people from a population based random sample of 3419 people, 40 years of age and older, participated in a telephone survey given in English, Cantonese, Mandarin, and Punjabi...
July 2006: Journal of Epidemiology and Community Health
Jim Christenson, Grant Innes, Douglas McKnight, Christopher R Thompson, Hubert Wong, Eugenia Yu, Barb Boychuk, Eric Grafstein, Frances Rosenberg, Kenneth Gin, Aslam Anis, Joel Singer
STUDY OBJECTIVE: Current risk stratification tools do not identify very-low-risk patients who can be safely discharged without prolonged emergency department (ED) observation, expensive rule-out protocols, or provocative testing. We seek to develop a clinical prediction rule applicable within 2 hours of ED arrival that would miss fewer than 2% of acute coronary syndrome patients and allow discharge within 2 to 3 hours for at least 30% of patients without acute coronary syndrome. METHODS: This prospective, cohort study enrolled consenting eligible subjects at least 25 years old at a single site...
January 2006: Annals of Emergency Medicine
Pauline T Truong, Freddy Abnousi, Celina M Yong, Allen Hayashi, James A Runkel, Theressa Phillips, Ivo A Olivotto
BACKGROUND: Currently, there is no standardized, comprehensive method to assess surgical scars after breast cancer surgery. This article evaluates the application of the Vancouver Scar Scale, in conjunction with patients' scar self-rating and scar-related pain, in a cohort of breast cancer patients. METHODS: Data were prospectively collected in 59 women with breast cancer. Scar assessment comprised: 1. objective rating by pairs of independent observers using the Vancouver Scar Scale; 2...
October 2005: Plastic and Reconstructive Surgery
Peter J Zed, Riyad B Abu-Laban, Travis M Cadieu, Roy A Purssell, Lyne Filiatrault
The purpose of this study was to evaluate the door-to-needle time for fibrinolytic administration for acute myocardial infarction (AMI) at Vancouver General Hospital (VGH) and identify factors associated with time prolongation. A retrospective chart review of all patients fibrinolysed for AMI in the ED at VGH was performed from January 1, 1998, to December 31, 1999, to determine door-to-needle time. A mixed-effects linear regression model was fit to the fibrinolytic data with the door-to-needle time to identify factors associated with prolonged times...
May 2004: American Journal of Emergency Medicine
Peggy A Wyatt, Pamela A Ratner
A telephone survey of 349 randomly-selected women living in Greater Vancouver was conducted to assess their understanding of acute myocardial infarction (AMI). The results revealed that women have not yet personalized AMI risk information. Participants indicated a need for more information pertaining to symptom recognition for AMI; they were largely unaware that females may experience AMI differently than do males. Participants were less aware of the risks that diabetes, obesity and menopause pose for AMI. Approximately 36% of these women intended to delay treatment-seeking in the presence of suspicious AMI symptoms...
2004: Canadian Journal of Cardiovascular Nursing, Journal Canadien en Soins Infirmiers Cardio-vasculaires
W D Weaver, K Sutherland, M J Wirkus, R Bachman
During the 1986 World's Exposition held in Vancouver, British Columbia, the types and frequencies of emergency medical problems were assessed. The average number of patients seeking care was 3.93 +/- 0.95 per 1,000 visitors (daily range, 1.94 to 6.8). Patient loads were linearly related to gate attendance, but the correlation was imperfect (P less than .001, r = .63). Only 4.4% of patients evaluated on site by nurses and paramedics were referred for additional testing and treatment: of these patients, 30% had suspected serious musculoskeletal injury, 16% had abdominal pain, and 25% had complaints of chest pain, dizziness, or loss of consciousness...
February 1989: Annals of Emergency Medicine
J Frohlich, A Brosseuk, A Grant, M McLennan
1. One hundred consecutive patients admitted with ischemic chest pain to the Emergency Department of Vancouver General Hospital were studied. The diagnosis was based on clinical assessment, EKG changes and the total CPK and LDH activities. However, unknown to the clinician. CPK and LDH isozyme determinations were also carried out and their possible impact on the diagnosis and management of the patients was evaluated retrospectively. In 37 patients with definitive myocardial infarction by all the above mentioned criteria the isozyme dterminations were of no further help...
December 1978: Clinical Biochemistry
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"