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Acute chest pain

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https://www.readbyqxmd.com/read/28090232/efficacy-and-safety-of-thrombolytic-therapy-in-acute-submassive-pulmonary-embolism-follow-up-study
#1
Santosh Kumar Sinha, Mohit Sachan, Amit Goel, Karandeep Singh, Vikas Mishra, Mukesh Jitendra Jha, Ashutosh Kumar, Nasar Abdali, Mohammad Asif, Mahamdula Razi, Umeshwar Pandey, Ramesh Thakur, Chandra Mohan Varma, Vinay Krishna
BACKGROUND: Thrombolysis in acute submassive pulmonary embolism (PE) remains controversial. So we studied impact of thrombolytic therapy in acute submassive PE in terms of mortality, hemodynamic status, improvement in right ventricular function, and safety in terms of major and minor bleeding. METHOD: A single-center, prospective, randomized study of 86 patients was conducted at LPS Institute of Cardiology, G.S.V.M. Medical College, Kanpur, India. Patients received thrombolysis (single bolus of tenecteplase) with unfractionated heparin (UFH, group I) or placebo with UFH (group II)...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28087181/challenging-the-99th-percentile-a-lower-troponin-cutoff-leads-to-low-mortality-of-chest-pain-patients
#2
Nils Arne Sörensen, Johannes Tobias Neumann, Francisco Ojeda, Tjark Schwemer, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Rule-out of non-ST-elevation myocardial infarction is based on consecutive measurements of cardiac troponins using the 99th percentile of the respective assay as cutoff. The new ESC guidelines alternatively offer rapid 1h algorithms with lower cutoffs than the 99th percentile for rule-out of non-ST-elevation myocardial infarction. We aimed to compare a recently introduced 1h algorithm based on a high-sensitivity cardiac troponin I (hs-TnI) cutoff of 6ng/L at 0h and 1h to the current standard of care using the 99th percentile (27ng/L) as cutoff with reference to follow-up events in a large chest pain cohort...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28081310/a-simple-risk-score-in-acute-st-elevation-myocardial-infarction-modified-acef-age-creatinine-and-ejection-fraction-score
#3
Arzu Kalaycı, Vecih Oduncu, Çetin Geçmen, Selim Topcu, Can Yücel Karabay, İbrahim Akın İzgi, Cevat Kırma
BACKGROUND/AIM: The aim of this study was to evaluate if the modified ACEF (age, creatinine, and ejection fraction) score is a predictor of major adverse cardiac and cerebrovascular events during 1 year of follow-up in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). MATERIALS AND METHODS: We retrospectively enrolled 1632 consecutive patients who were admitted to our emergency department diagnosed with STEMI within 12 h of chest pain and treated with primary PCI...
December 20, 2016: Turkish Journal of Medical Sciences
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
#4
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
#5
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/28063854/hospital-admissions-for-chest-pain-associated-with-cocaine-use-in-the-united-states
#6
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
#7
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
#8
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
#9
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/28056838/first-case-report-of-myopericarditis-linked-to-campylobacter-coli-enterocolitis
#10
Cameron R M Moffatt, Soniah B Moloi, Karina J Kennedy
BACKGROUND: Campylobacter spp. are a common cause of mostly self-limiting enterocolitis. Although rare, pericarditis and myopericarditis have been increasingly documented as complications following campylobacteriosis. Such cases have occurred predominantly in younger males, and involved a single causative species, namely Campylobacter jejuni. We report the first case of myopericarditis following Campylobacter coli enterocolitis, with illness occurring in an immunocompetent middle-aged female...
January 5, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28054396/incremental-value-of-contrast-echocardiography-in-the-evaluation-of-a-cardiac-thrombus
#11
Jose Ricardo F Po, Matthew S Tong, Erica L Grove, Robert W W Biederman
A 52-year-old man presented with altered mental status and report of prior complaint of chest pain. On electrocardiography, anterolateral ST-segment elevations with Q-waves in the septal leads were seen. Initial echocardiography images demonstrated a thickened anteroseptum. Further imaging showed the presence of a well-attached laminated apical thrombus. Contrast echocardiography images showed that the thrombus had minimal attachment to the endocardial surface. CT head subsequently showed the presence of acute stroke...
January 5, 2017: Echocardiography
https://www.readbyqxmd.com/read/28051221/contribution-of-cardiac-magnetic-resonance-imaging-in-the-diagnosis-of-acute-coronary-syndrome-with-normal-coronary-angiography
#12
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/28041756/trauma-induced-acute-myocardial-infarction-due-to-delayed-dissection-of-the-left-anterior-descending-coronary-artery
#13
Magdalena Wilczynska-Golonka, Pawel Rostoff, Aleksander Siniarski, Agnieszka Skrzypek, Andrzej Gackowski, Ewa Konduracka, Jadwiga Nessler
Acute myocardial infarction is a very rare, life-threatening complication of blunt chest trauma. A 27-year-old man with no previous medical history was admitted to the emergency department due to multiple trauma following a car accident. After 48h following the accident, the patient's condition rapidly deteriorated, with severe dyspnea at rest, tachycardia, and increasing chest pain. A 12-lead ECG showed a sinus tachycardia at 120bpm with significant ST-segment elevation in leads V1 to V5, pathologic Q wave in I, aVL, and QS complex in leads V1 to V4...
December 27, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28038722/management-standards-for-stable-coronary-artery-disease-in-india
#14
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/28033243/prognostic-values-of-4-risk-scores-in-chinese-patients-with-chest-pain-prospective-2-centre-cohort-study
#15
Xiao-Hui Chen, Hui-Lin Jiang, Yun-Mei Li, Cangel Pui Yee Chan, Jun-Rong Mo, Chao-Wei Tian, Pei-Yi Lin, Colin A Graham, Timothy H Rainer
Four risk scores for stratifying patients with chest pain presenting to emergency departments (EDs) (namely Thrombolysis in myocardial infarction [TIMI], Global registry for acute coronary events [GRACE], Banach and HEART) have been developed in Western settings but have never been compared and validated in Chinese patients. We aimed to find out to the number of MACE within 7 days, 30 days, and 6 months after initial ED presentation, and also to compare the prognostic performance of these scores in Chinese patients with suspected cardiac chest pain (CCP) to predict 7-day, 30-day, and 6-month major adverse cardiac events (MACE)...
December 2016: Medicine (Baltimore)
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
#16
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
https://www.readbyqxmd.com/read/28027742/prognostic-value-of-ct-derived-left-atrial-and-left-ventricular-measures-in-patients-with-acute-chest-pain
#17
Richard A P Takx, Rozemarijn Vliegenthart, U Joseph Schoepf, John W Nance, Fabian Bamberg, Joseph A Abro, Christine M Carr, Sheldon E Litwin, Paul Apfaltrer
PURPOSE: To determine which left atrial (LA) and left ventricular (LV) parameters are associated with future major adverse cardiac event (MACE) and whether these measurements have independent prognostic value beyond risk factors and computed tomography (CT)-derived coronary artery disease measures. MATERIALS AND METHODS: This retrospective analysis was performed under an IRB waiver and in HIPAA compliance. Subjects underwent coronary CT angiography (CCTA) using a dual-source CT system for acute chest pain evaluation...
January 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28027073/value-of-the-coronary-artery-disease-consortium-rule-in-patients-with-acute-chest-pain-and-negative-troponins-referred-for-exercise-stress-testing
#18
Alberto Bouzas-Mosquera, Jesús Peteiro, Francisco J Broullón, Ramón Calviño-Santos, Víctor X Mosquera, Dolores Martínez, Juan C Yáñez, Nemesio Álvarez-García, José M Vázquez-Rodríguez
OBJECTIVE: To assess the value of the pretest probability (PTP) of coronary artery disease (CAD) for predicting stress testing results and coronary events in patients with acute chest pain and negative troponins. PATIENTS AND METHODS: A total of 3527 patients without a history of CAD referred to our chest pain unit with suspected acute coronary syndromes, nondiagnostic ECGs, and negative troponin levels underwent exercise stress testing. PTP was estimated with the CAD consortium prediction rule, and was categorized as low (<15%), low-intermediate (15-65%), intermediate-high (66-85%), and high (>85%)...
December 23, 2016: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28024553/sustained-performance-of-a-physicianless-system-of-automated-prehospital-stemi-diagnosis-and-catheterization-laboratory-activation
#19
Brian J Potter, Alexis Matteau, Samer Mansour, Charbel Naim, Mounir Riahi, Richard Essiambre, Martine Montigny, Isabelle Sareault, François Gobeil
BACKGROUND: Treatment times for primary percutaneous coronary intervention frequently exceed the recommended maximum delay. Automated "physicianless" systems of prehospital cardiac catheterization laboratory (CCL) activation show promise, but have been met with resistance over concerns regarding the potential for false positive and inappropriate activations (IAs). METHODS: From 2010 to 2015, first responders performed electrocardiograms (ECGs) in the field for all patients with a complaint of chest pain or dyspnea...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28018820/acute-pulmonary-artery-obstruction-as-the-primary-manifestation-of-a-rapidly-growing-intimal-sarcoma-in-a-54-year-old-patient
#20
Sumi Westhofen, Christian Kugler, Hermann Reichenspurner, Tobias Deuse
Pulmonary artery sarcoma is a rare malignant neoplasm that is often misdiagnosed and most often only recognized postmortem during the autopsy. We present the case of a male patient with a rapidly progressive pulmonary tumor who underwent urgent pneumonectomy for increasing symptoms of chest pain and septic clinical picture. Histological analysis revealed the diagnosis of a pulmonary artery sarcoma. Despite an R1-resection and adjuvant chemotherapy, the patient is in good clinical health and free of tumor relapse 1 year after the surgery...
December 2016: Thoracic and Cardiovascular Surgeon Reports
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