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Acute chest pain

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https://www.readbyqxmd.com/read/28343155/more-than-just-muscle-spasms-a-rare-presentation-of-aortic-dissection
#1
Ebisa Bekele, Deepthi Chaitanya Kagolanu, Martin Kim, Kent Stephenson
Acute aortic dissection is associated with significant morbidity and mortality, often from complications including aortic regurgitation, cardiac tamponade and myocardial infarction. Typical clinical presentation includes a sudden onset of severe chest pain, although this is not always consistent. Clinical signs and symptoms are diverse with an estimated 38% of cases being missed on initial evaluation. Primary neurological symptoms at presentation are rare but have been reported often to coexist with chest pain...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28328689/adult-chest-pain-in-the-pediatric-emergency-department-treatment-and-timeliness-from-door-in-to-door-out
#2
Jeffrey H Sacks, Peter B Flueckiger, Philip R Spandorfer, William T Mahle, Brian E Costello
OBJECTIVES: The American College of Cardiology Foundation/American Heart Association guidelines for acute coronary syndrome (ACS) recommend immediate aspirin (ASA) administration, an electrocardiogram (ECG) in less than 10 minutes, and a door-in to door-out (DIDO) time less than 30 minutes for interfacility transfer. We sought to determine if compliance is hindered when adults with suspected ACS present to pediatric facilities. METHODS: Visits to the 2 tertiary care emergency departments of a pediatric healthcare system using an adult chest pain protocol were examined from October 2006 to September 2012...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28325613/head-to-head-comparison-of-the-diagnostic-performance-of-coronary-computed-tomography-angiography-and-dobutamine-stress-echocardiography-in-the-evaluation-of-acute-chest-pain-with-normal-ecg-findings-and-negative-troponin-tests-a-prospective-multicenter-study
#3
Eric Durand, Fabrice Bauer, Nicolas Mansencal, Arshid Azarine, Benoit Diebold, Albert Hagege, Ludivine Perdrix, Martine Gilard, Yannick Jobic, Hélène Eltchaninoff, Mourad Bensalah, Benjamin Dubourg, Jérôme Caudron, Ralph Niarra, Gilles Chatellier, Jean-Nicolas Dacher, Elie Mousseaux
OBJECTIVE: To perform a head-to-head comparison of coronary CT angiography (CCTA) and dobutamine-stress echocardiography (DSE) in patients presenting recent chest pain when troponin and ECG are negative. METHODS: Two hundred seventeen patients with recent chest pain, normal ECG findings, and negative troponin were prospectively included in this multicenter study and were scheduled for CCTA and DSE. Invasive coronary angiography (ICA), was performed in patients when either DSE or CCTA was considered positive or when both were non-contributive or in case of recurrent chest pain during 6month follow-up...
March 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28325612/cost-effectiveness-of-high-sensitivity-troponin-compared-to-conventional-troponin-among-patients-presenting-with-undifferentiated-chest-pain-a-trial-based-analysis
#4
Billingsley Kaambwa, Julie Ratcliffe, Matthew Horsfall, Carolyn Astley, Jonathan Karnon, Penelope Coates, Margaret Arstall, Christopher Zeitz, Matthew Worthley, John Beltrame, Derek P Chew
BACKGROUND: Patients with low and intermediate risk chest pain features comprise the greatest proportion presenting to emergency services for evaluation of suspected acute coronary syndromes (ACS). The efficient and timely identification of patients with these features remains a major challenge within clinical practice. Troponin assays are increasingly being used for the determination of risk among patients presenting with chest pain potentially facilitating more appropriate care. To date, no economic evaluation comparing high-sensitivity troponin T (hs-TnT) reporting to standard troponin T (c-TnT) reporting in the routine management of suspected ACS and based on longer-term clinical outcomes has been conducted...
March 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28319162/risk-of-acute-myocardial-infarction-in-patients-with-gastroesophageal-reflux-disease-a-nationwide-population-based-study
#5
Wei-Yi Lei, Jen-Hung Wang, Shu-Hui Wen, Chih-Hsun Yi, Jui-Sheng Hung, Tso-Tsai Liu, William C Orr, Chien-Lin Chen
OBJECTIVE: Gastroesophageal reflux disease (GERD) is a common disease which can cause troublesome symptoms and affect quality of life. In addition to esophageal complications, GERD may also be a risk factor for extra-esophageal complications. Both GERD and coronary artery disease (CAD) can cause chest pain and frequently co-exist. However, the association between GERD and acute myocardial infarction (AMI) remain unclear. The purpose of the study was to compare the incidence of acute myocardial infarction in GERD patients with an age-, gender-, and comorbidity matched population free of GERD...
2017: PloS One
https://www.readbyqxmd.com/read/28316858/spontaneous-intramural-oesophageal-haematoma-in-a-patient-with-uncontrolled-hypertension-an-unusual-chest-pain-aetiology
#6
Samantha Cooray, Dionysios Dellaportas, Clifford Caruana, Andrew R Davies
Introduction. Spontaneous intramural oesophageal haematoma is a rare condition that usually occurs secondary to an acute or chronic coagulation disorder. The presenting complaint is often with retrosternal chest pain and most patients are initially investigated to exclude more common causes in the differential diagnosis, such as acute coronary syndromes. Severe life-threatening bleeding or perforation seldom, if ever, arises. Case Presentation. We present a case of spontaneous oesophageal haematoma which appears to have developed gradually in a 69-year-old female with uncontrolled hypertension and antiplatelet medication use...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28304194/out-of-hospital-cardiac-arrest-survivors-sent-for-emergency-angiography-a-clinical-score-for-predicting-acute-myocardial-infarction
#7
Floriane Zeyons, Laurence Jesel, Olivier Morel, Hélène Kremer, Nathan Messas, Sebastien Hess, Ulun Crimizade, Philippe Reydel, Laurent Tritsch, Patrick Ohlmann
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) remains a major public health issue. Emergency coronary angiography and percutaneous coronary intervention might improve survival, especially when cardiac arrest is caused by acute myocardial infarction (AMI). However, identifying patients with AMI after OHCA remains challenging. The aim of this study was to determine the clinical and ECG criteria in OHCA that may help to identify better the patients with AMI. METHODS: Consecutive OHCA patients who underwent emergency coronary angiography in our centre between 2009 and 2013 were included in this retrospective single-centre observational study...
March 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28294330/triple-branched-stent-graft-for-arch-repair-in-a-pregnant-woman-with-acute-debakey-type-i-aortic-dissection
#8
Qian Zhang, Xiaochun Ma, Zhengjun Wang, Chengwei Zou
A woman aged 36 years at 36 weeks of pregnancy sought medical attention at the Shandong Provincial Hospital affiliated to Shandong University, Shandong, China, after experiencing acute chest pain. The patient was diagnosed with chronic hypertension, severe pre-eclampsia, acute aortic dissection, aortic regurgitation, and heart failure. Computed tomography examination demonstrated a DeBakey type I aortic dissection that involved the origin of the innominate artery, the left common carotid artery, and the left subclavian artery...
March 12, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28293403/hydroxycarbamine-from-an-old-drug-used-in-malignant-hemopathies-to-a-current-standard-in-sickle-cell-disease
#9
REVIEW
Giovanna Cannas, Solène Poutrel, Xavier Thomas
While hydroxycarbamide (hydroxyurea, HU) has less and fewer indications in malignant hemopathies, it represents the only widely used drug which modifies sickle cell disease pathogenesis. Clinical experience with HU for patients with sickle cell disease has been accumulated over the past 25 years in Western countries. The review of the literature provides increasing support for safety and efficacy in both children and adults for reducing acute vaso-occlusive events including pain episodes and acute chest syndrome...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28292380/correlation-of-c-reactive-protein-and-cardiac-enzymes-with-angiographic-severity-of-coronary-artery-disease-in-pakistani-patients-with-acute-coronary-syndrome
#10
Ayesha Saleem, Azmat Ali
OBJECTIVE: To determine the correlation of C-reactive protein (CRP) levels with the severity of coronary stenosis on angiography and the association of cardiac enzymes with the degree of stenosis in acute coronary syndrome (ACS) patients. Secondly, to compare association of angiographic severity of vascular stenosis with CRP in patients with ST segment elevation myocardial infarction (STEMI) and non-STEMI / Unstable angina (UA). STUDY DESIGN: Prospective, descriptive study...
February 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28289555/gender-differences-in-post-traumatic-stress
#11
Maria Grazia Modena, Daniele Pettorelli, Giulia Lauria, Elisa Giubertoni, Erminio Mauro, Valentina Martinotti
Acute stress can trigger cardiovascular events and disease. The earthquake is an "ideal" natural experiment for acute and chronic stress, with impact mainly on the cardiovascular system. On May 20th and 29th, 2012, two earthquakes of magnitude 5.9° to 6.4° on the Richter scale, hit the province of Modena and Reggio Emilia, an area of the north-center of Italy never considered at seismic risk. The purpose of our study was to assess whether there were gender-specific differences in stress-induced incidence of cardiovascular events and age of patients who arrived at the Emergency Departments (ED) of the three main teaching hospitals of the University of Modena and Reggio Emilia...
2017: BioResearch Open Access
https://www.readbyqxmd.com/read/28288049/catecholamine-induced-chest-pain-mimicking-infarction-due-to-an-mibg-negative-and-dopa-positive-succinate-dehydrogenase-syndrome-subunit-b-related-pheochromocytoma
#12
Alberto Mazza, Alice Ferretti, Antonella Paola Sacco, Domenico Rubello, Patrick M Colletti
This 16-year-old boy presented with acute retrosternal pain possibly representing acute myocardial infarction. Cardiac enzymes were within reference ranges. There were marked increases in metanephrine to 3299 μg/24 h (reference, <400 μg/24 h), normetanephrine to 1309 μg/24 h (reference, 0-390 μg/24 h), and chromogranin A to 1605 ng/mL (reference, 0-150 μg/24 h). An incidental left adrenal mass was found during CTPA performed to exclude pulmonary embolism. I-MIBG scintigraphy was negative, and genetic screening detected SDHB (succinate dehydrogenase syndrome subunit B) gene mutation...
March 10, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28286825/screening-characteristics-of-timi-score-in-predicting-acute-coronary-syndrome-outcome-a-diagnostic-accuracy-study
#13
Mostafa Alavi-Moghaddam, Saeed Safari, Hamideh Alavi-Moghaddam
INTRODUCTION: In cases with potential diagnosis of ischemic chest pain, screening high risk patients for adverse outcomes would be very helpful. The present study was designed aiming to determine the diagnostic accuracy of thrombolysis in myocardial infarction (TIMI) score in Patients with potential diagnosis of ischemic chest pain. METHOD: This diagnostic accuracy study was designed to evaluate the screening performance characteristics of TIMI score in predicting 30-day outcomes of mortality, myocardial infarction (MI), and need for revascularization in patients presenting to ED with complaint of typical chest pain and diagnosis of unstable angina or Non-ST elevation MI...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28286818/validation-of-the-north-american-chest-pain-rule-in-prediction-of-very-low-risk-chest-pain-a-diagnostic-accuracy-study
#14
Somayeh Valadkhani, Mohammad Jalili, Elham Hesari, Hadi Mirfazaelian
INTRODUCTION: Acute coronary syndrome accounts for more than 15% of the chest pains. Recently, Hess et al. developed North American Chest Pain Rule (NACPR) to identify very low-risk patients who can be safely discharged from emergency department (ED). The present study aimed to validate this rule in EDs of two academic hospitals. METHODS: A prospective diagnostic accuracy study was conducted on consecutive patients 24 years of age and older presenting to the ED with the chief complaint of acute chest pain, during March 2013 to June 2013...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285712/the-value-of-reciprocal-electrocardiographic-leads
#15
Mazen M Kawji, David L Glancy
In a woman with chest pain, <0.1 mV ST-segment elevation in lead III, and virtually no ST elevation in leads II and aVF, striking ST-segment depression in lead aVL, the reciprocal lead to lead III, confirmed the diagnosis of acute inferior myocardial infarction.
February 20, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28283286/prophylactic-platelet-transfusion-plus-supportive-care-versus-supportive-care-alone-in-adults-with-dengue-and-thrombocytopenia-a-multicentre-open-label-randomised-superiority-trial
#16
David C Lye, Sophia Archuleta, Sharifah F Syed-Omar, Jenny G Low, Helen M Oh, Yuan Wei, Dale Fisher, Sasheela S L Ponnampalavanar, Limin Wijaya, Linda K Lee, Eng-Eong Ooi, Adeeba Kamarulzaman, Lucy C Lum, Paul A Tambyah, Yee-Sin Leo
BACKGROUND: Dengue is the commonest vector-borne infection worldwide. It is often associated with thrombocytopenia, and prophylactic platelet transfusion is widely used despite the dearth of robust evidence. We aimed to assess the efficacy and safety of prophylactic platelet transfusion in the prevention of bleeding in adults with dengue and thrombocytopenia. METHODS: We did an open-label, randomised, superiority trial in five hospitals in Singapore and Malaysia...
March 7, 2017: Lancet
https://www.readbyqxmd.com/read/28282364/lung-ultrasound-for-the-regional-anesthesiologist-and-acute-pain-specialist
#17
Stephen C Haskins, Ban C Tsui, Jemiel A Nejim, Christopher L Wu, Jan Boublik
In this article, we discuss the emerging role of lung point-of-care ultrasonography for regional anesthesiologists and pain management specialists. Lung ultrasonography is a well-established clinical tool that is used on a routine basis in emergency rooms and critical care units internationally to evaluate patients with respiratory distress; however, its benefits to the regional anesthesiologist and pain specialist are not as well known and are practiced less frequently. This review article covers the clinical evidence in support of lung point-of-care ultrasonography as a rapid and superior tool to traditional imaging modalities such as chest radiography and fluoroscopy...
March 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28279383/out-with-the-old-rule-out-raising-the-bar-for-acute-chest-pain-evaluation-with%C3%A2-randomized-trials-of-cardiac-imaging
#18
EDITORIAL
Deepak L Bhatt, Viviany R Taqueti
No abstract text is available yet for this article.
March 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28279382/trials-of-imaging-use-in-the-emergency-department-for-acute-chest-pain
#19
REVIEW
Gilbert L Raff, Udo Hoffmann, James E Udelson
Over 8 million patients seek emergency department care for acute chest pain annually in the United States alone, and <5% have an acute coronary syndrome. In the absence of overt electrocardiographic or biomarker evidence, expensive and time-consuming diagnostic strategies are frequently required. Beginning in 2000, radionuclide myocardial perfusion, stress echocardiography, cardiac magnetic resonance imaging, and coronary computed tomographic angiography have become increasingly common in evaluating these patients...
March 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28275421/treating-a-structural-heart-disease-using-a-non-structural-approach-role-of-cardiac-pacing-in-hypertrophic-cardiomyopathy
#20
Bernard Benjamin P Albano, Erdie C Fadreguilan, Jeffrey M Chua, James Ho, Ana Beatriz Medrano
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease characterized by a thickened non-dilated ventricle in the absence of another cardiac or systemic condition. Its most important hemodynamic consequence is left ventricular outflow tract (LVOT) obstruction. The primary management strategy of this condition is surgical septal myectomy, but an acceptable alternative treatment in patients who are not suitable for (or who refuse) surgery is alcohol septal ablation (ASA). However, in patients with unfavorable coronary anatomy which precludes ASA (i...
February 2017: Cardiology Research
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