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Acute chest pain

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https://www.readbyqxmd.com/read/28918410/-just-like-a-normal-pain-what-do-people-with-diabetes-mellitus-experience-when-having-a-myocardial-infarction-a-qualitative-study-recruited-from-uk-hospitals
#1
Nikita Berman, Melvyn Mark Jones, Daan A De Coster
OBJECTIVE: The objective of the study was to investigate the symptoms people with diabetes experience when having a myocardial infarction (MI), their illness narrative and how they present their symptoms to the health service. SETTING: Three London (UK) hospitals (coronary care units and medical wards). PARTICIPANTS: Patients were recruited with diabetes mellitus (DM) (types 1 and 2) with a clinical presentation of MI (ST elevated MI (STEMI), non-ST elevated MI (NSTEMI), acute MI unspecified and cardiac arrest)...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28916174/evaluation-of-beat-to-beat-ventricular-repolarization-lability-from-standard-12-lead-ecg-during-acute-myocardial-ischemia
#2
Salah S Al-Zaiti, Mohammad Alrawashdeh, Christian Martin-Gill, Clifton Callaway, David Mortara, Jan Nemec
BACKGROUND: Acute myocardial ischemia is a common cause of ventricular arrhythmias, yet recent ECG methods predicting susceptibility to ventricular tachyarrhythmia have not been fully evaluated during spontaneous ischemia. We sought to evaluate the clinical utility of alternans and non-alternans components of repolarization variability from the standard 10-second 12-lead ECG signals to risk stratify patients with acute chest pain. METHODS: We enrolled consecutive, non-traumatic, chest pain patients transported through Emergency Medical Services (EMS) to three tertiary care hospitals with cardiac catheterization lab capabilities in Pittsburgh, PA...
August 10, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28915139/left-and-right-ventricular-morphology-function-and-late-gadolinium-enhancement-extent-and-localization-change-with-different-clinical-presentation-of-acute-myocarditis-data-from-the-italian-multicenter-study-on-myocarditis-itamy
#3
Gianluca Di Bella, Giovanni Camastra, Lorenzo Monti, Santo Dellegrottaglie, Paolo Piaggi, Claudio Moro, Alessia Pepe, Chiara Lanzillo, Gianluca Pontone, Martina Perazzolo Marra, Mauro Di Roma, Alessandra Scatteia, Giovanni D Aquaro
AIMS: Poor data exist about cardiac magnetic resonance (CMR) findings in a large sample of acute myocarditis with different clinical presentations (heart failure, arrhythmias, and infarct-like presentation). METHODS: Five hundred and forty-three in-patients with a clinical suspected of acute myocarditis confirmed by CMR were enrolled. The clinical indications to perform CMR were chest pain and/or dyspnea and/or palpitations, or effort intolerance/malaise in the last month; elevated troponin and/or new ventricular dysfunction, and/or new ECG abnormalities; and suspected inflammatory cause...
September 14, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28913922/a-clinically-meaningful-fetal-hemoglobin-threshold-for-children-with-sickle-cell-anemia-during-hydroxyurea-therapy
#4
Jeremie H Estepp, Matthew P Smeltzer, Guolian Kang, Chen Li, Winfred C Wang, Christina Abrams, Banu Aygun, Russell E Ware, Kerri Nottage, Jane S Hankins
Hydroxyurea has proven clinical benefits and is recommended to be offered to all children with sickle cell anemia (SCA), but the optimal dosing regimen remains controversial. Induction of red blood cell fetal hemoglobin (HbF) by hydroxyurea appears to be dose-dependent. However, it is unknown whether maximizing HbF% improves clinical outcomes. HUSTLE (NCT00305175) is a prospective observational study with a primary goal of describing the long-term clinical effects of hydroxyurea escalated to maximal tolerated dose (MTD) in children with SCA...
September 14, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28913755/management-and-clinical-outcome-of-stable-coronary-artery-disease-in-austria-results-from-5%C3%A2-years-of-the-clarify-registry
#5
Irene M Lang, Roza Badr-Eslam, Nicola Greenlaw, Robin Young, Philippe Gabriel Steg
BACKGROUND: The population of patients with established coronary artery disease (CAD) is growing because of an improvement in outcomes and survival from acute disease episodes. Nevertheless, these patients remain at high risk of cardiovascular events. Thus, CAD management is important in prevention of disease progression. The objective of this analysis was to describe disease management and clinical outcome of Austrian outpatients with stable CAD over 5 years by using data from the international CLARIFY registry...
September 14, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28904006/the-crash-report-emergency-management-dilemmas-facing-acute-physicians-in-patients-with-pulmonary-arterial-hypertension
#6
Laura C Price, Konstantinos Dimopoulos, Philip Marino, Rafael Alonso-Gonzalez, Colm McCabe, Aleksander Kemnpy, Lorna Swan, Maria Boutsikou, Ahmed Al Zahrani, Gerry J Coghlan, Benjamin E Schreiber, Luke S Howard, Rachel Davies, Mark Toshner, Joanna Pepke-Zaba, Alistair C Church, Andrew Peacock, Paul A Corris, James L Lordan, Sean Gaine, Robin Condliffe, David G Kiely, Stephen John Wort
Treatment of acute emergencies in patients with pulmonary arterial hypertension (PAH) can be challenging. In the UK and Ireland, management of adult patients with PAH is centred in eight nationally designated pulmonary hypertension (PH) centres. However, many patients live far from these centres and physicians in local hospitals are often required to manage PAH emergencies. A committee of physicians from nationally designated PH centres identified the 'most common' emergency clinical scenarios encountered in patients with PAH...
September 12, 2017: Thorax
https://www.readbyqxmd.com/read/28901858/expression-of-a-nitric-oxide-synthesizing-protein-in-arterial-endothelial-cells-in-response-to-different-anti-anginal-agents-used-in-acute-coronary-syndromes
#7
Sarbashri Bank, Pradipta Jana, G V Girish, Asru Sinha, Smarajit Maiti
Organic "nitro" compounds such as nitroglycerine, isosorbate nitrate are useful in the control of chest pain in acute coronary syndrome. But the mechanism of it in pain regulation remains speculative. Here, increase of NO production was investigated by the possible regulation of constitutive nitric oxide synthase (cNOS) function from goat arterial endothelial cells. This protein was purified and sequence wise characterized as protein disulfide isomerase (PDI) in response to different nitro compounds. The NO generating protein was isolated from arterial endothelial cells and prepared to homogeneity...
September 11, 2017: Protein and Peptide Letters
https://www.readbyqxmd.com/read/28900861/acute-kidney-injury-caused-by-decompression-illness-successfully-treated-with-hyperbaric-oxygen-therapy-and-temporary-dialysis
#8
Arata Hibi, Keisuke Kamiya, Takahisa Kasugai, Keisuke Kamiya, Satoru Kominato, Chiharu Ito, Toshiyuki Miura, Katsushi Koyama
A 52-year-old Japanese male professional diver was referred to our hospital for decompression illness (DCI). After 1 h of diving operation at 20 m below sea level, he complained of dyspnea, chest pain, and abdominal pain. He dove again, intending to ease the symptoms, but the symptoms were never relieved. He dove for a total of 4 h. No neurological abnormalities were observed. Computed tomography images revealed portal venous gas and mesenteric venous gas, in addition to bubbles in the femoral veins, pelvis, lumbar canal, intracranial sinuses, and joints...
September 12, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28893673/extracorporeal-membrane-oxygenation-ecmo-as-salvage-treatment-for-pulmonary-echinococcus-granulosus-infection-with-acute-cyst-rupture
#9
Sören L Becker, Sebastian Fähndrich, Franziska C Trudzinski, Barbara Gärtner, Frank Langer, Torben K Becker, Robert Bals, Philipp M Lepper, Christian Lensch
Extracorporeal membrane oxygenation (ECMO) has been successfully used for the treatment of patients with respiratory failure due to severe infections. Though rare, parasites can also cause severe pulmonary disease. Tapeworms of the genus Echinococcus give rise to the development of cystic structures in the liver, lungs and other organs. Acute cyst rupture leads to potentially life-threatening infection, and affected patients may deteriorate rapidly. We describe the case of a young woman from Bulgaria who was admitted to hospital with severe dyspnoea, progressive chest pain and haemoptysis...
September 8, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28889147/acute-coronary-syndrome-risk-prediction-of-rapid-emergency-medicine-scoring-system-in-acute-chest-pain-an-observational-study-of-patients-presenting-with-chest-pain-in-the-emergency-department-in-central-saudi-arabia
#10
Tahir Mehmood, Mohammad S Al Shehrani, Muhammad Ahmad
To assess the diagnostic validity of the rapid emergency medical score (REMS) for the risk stratification of acute coronary syndrome (ACS) from non-cardiogenic chest pain. Methods: An observational cross-sectional study was carried out among patients presenting with chest pain to the Emergency Department of Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia, for 6 months from January to June 2016. All patients, included through non-probability convenience sampling, were assessed using standard protocols for the physiological parameters of the REMS, and ACS was confirmed through electrocardiography, cardiac enzyme testing, and angiography (if needed)...
September 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28888269/depression-is-associated-with-recurrent-chest-pain-with-or-without-coronary-artery-disease-a-prospective-cohort-study-in-the-emergency-department
#11
Yeunjung Kim, Morgan Soffler, Summer Paradise, Qurat-Ul-Ain Jelani, James Dziura, Rajita Sinha, Basmah Safdar
BACKGROUND: Only a small fraction of acute chest pain in the emergency department (ED) is due to obstructive coronary artery disease (CAD). ED chest pain remains associated with high rates of recidivism, often in the presence of nonobstructive CAD. Psychological states such as depression, anxiety, and elevation of perceived stress may account for this finding. The objective of the study was to determine whether psychological states predict recurrent chest pain (RCP). METHODS: We conducted a prospective cohort study of low- to moderate-cardiac risk ED patients admitted to the Yale Chest Pain Center with acute chest pain...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28884028/spontaneous-coronary-artery-dissection-a-rare-manifestation-of-alport-syndrome
#12
Amornpol Anuwatworn, Prince Sethi, Kelly Steffen, Orvar Jonsson, Marian Petrasko
Alport syndrome (AS) is a genetic disorder due to inheritance of genetic mutations which lead to production of abnormal type IV collagen. AS has been associated with renal, auditory, and ocular diseases due to the presence of abnormal alpha chains of type IV collagen in the glomerulus, cochlea, cornea, lens, and retina. The resulting disorder includes hereditary nephritis, corneal opacities, anterior lenticonus, fleck retinopathy, temporal retinal thinning, and sensorineural deafness. Aortic and aortic valve pathologies have been described as extrarenal manifestations of AS in multiple case reports...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28877730/pancreas-herniation-into-the-mediastinum-a-case-report
#13
Muhammad Shafiq, Moaviz B Badshah, Maaz B Badshah, Mashood B Badshah, James Watkins
BACKGROUND: Pancreatic tissue found in the mediastinum (both true ectopic and herniated pancreas) is rare. It becomes even more challenging when there are complications associated with this entity. CASE PRESENTATION: We report an unusual case of pancreatic herniation into the mediastinum in a 90-year-old Caucasian female. This patient initially presented with nausea and vomiting associated with abdominal pain. Serum lipase and amylase both were elevated. Computed tomography scan of the chest, abdomen and pelvis revealed a large hiatal hernia with pancreas herniation into the mediastinum, with superimposed acute pancreatitis likely due to gallstone...
September 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28876686/management-of-failed-mitral-valve-replacement-the-durban-experience
#14
D Kistan, M Booysen, G Alexander, T E Madiba
BACKGROUND: Mitral valve replacement is the procedure of choice in patients with severe mitral valve disease. However, these patients are surviving longer and are thus at an increased risk of prosthesis failure or valve-related complications. METHOD: Study setting: Inkosi Albert Luthuli Central Hospital, a tertiary referral Hospital in Durban. Study population: All patients undergoing redo mechanical mitral valve replacement surgery between January 2005 and December 2014...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876423/thrombosed-aneurysm-of-saphenous-vein-coronary-artery-bypass-grafting
#15
Rodolfo Mendes Queiroz, Rogério Nastri, Marcus Antônio Ferez, Mauro José Brandão da Costa, Claudio Benedini Laguna, Marcus Vinicius Nascimento Valentin
We describe the case of a male patient, aged 76 years, referred for cardiac investigation due to retrosternal chest pain and dyspnea. He had a history of acute myocardial infarction and angioplasties in the last 30 years, including a saphenous vein coronary artery bypass grafting (SVCABG). Echocardiogram showed hypoechoic oval formation near the right ventricle, suggesting a pericardial cyst. Computed angiotomography revealed a predominantly fusiform and thrombosed aneurysmal dilation of the SVCABG to the right coronary artery...
June 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28875364/age-and-sex-based-resource-utilisation-and-costs-in-patients-with-acute-chest-pain-undergoing-cardiac-ct-angiography-pooled-evidence-from-romicat-ii-and-acrin-pa-trials
#16
Fabian Bamberg, Thomas Mayrhofer, Maros Ferencik, Daniel O Bittner, Travis R Hallett, Sumbal Janjua, Christopher L Schlett, John T Nagurney, James E Udelson, Quynh A Truong, Pamela K Woodard, Judd E Hollander, Harold Litt, Udo Hoffmann
OBJECTIVES: To determine resource utilisation according to age and gender-specific subgroups in two large randomized diagnostic trials. METHODS: We pooled patient-specific data from ACRIN-PA 4005 and ROMICAT II that enrolled subjects with acute chest pain at 14 US sites. Subjects were randomized between a standard work-up and a pathway utilizing cardiac computed tomography angiography (CCTA) and followed for the occurrence of acute coronary syndrome (ACS) and resource utilisation during index hospitalisation and 1-month follow-up...
September 5, 2017: European Radiology
https://www.readbyqxmd.com/read/28871936/xanthoma-like-skin-changes-in-an-elderly-woman-with-a-normal-lipid-profile
#17
Piotr Nockowski, Zdzisław Woźniak, Adam Reich, Joanna Maj
Dear Editor, An 83-year-old woman developed yellow-brownish infiltrates, nodules, and tumors mimicking xanthomas, mostly involving the periorbital and chest area within three months (Figure 1). She had no abnormalities in serum cholesterol or triglycerides levels. A detailed laboratory analysis revealed the presence of mild monoclonal gammopathy with a presence of immunoglobulin G (IgG) kappa light chains; however, according to hematologist consultation, it did not require medical intervention. Imaging assessment and ultrasound examination did not show any specific involvement of internal organs...
July 2017: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28871571/acute-aortic-dissection-pathogenesis-risk-factors-and-diagnosis
#18
Joanna Gawinecka, Felix Schönrath, Arnold von Eckardstein
Acute aortic dissection is a rare but life-threatening condition with a lethality rate of 1 to 2% per hour after onset of symptoms in untreated patients. Therefore, its prompt and proper diagnosis is vital to increase a patient's chance of survival and to prevent grievous complications. Typical symptoms of acute aortic dissection include severe chest pain, hypotension or syncope and, hence, mimic acute myocardial infarction or pulmonary embolism. Advanced age, male gender, long-term history of arterial hypertension and the presence of aortic aneurysm confer the greatest population attributable risk...
September 5, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28870153/myocardial-infarction-during-anaphylaxis-in-a-young-healthy-male-with-normal-coronary-arteries-is-epinephrine-the-culprit
#19
W D Jayamali, H M M T B Herath, Aruna Kulathunga
BACKGROUND: Anaphylaxis is an acute, potentially fatal medical emergency. Myocardial injury or infarction in the setting of an anaphylaxis can be due the anaphylaxis itself, when it is known as Kounis syndrome or it can also be due to the effect of epinephrine treatment. Epinephrine is considered as the cornerstone in management of anaphylaxis. Myocardial infarction secondary to therapeutic doses of adrenaline is a rare occurrence and only a few cases have been reported in literature...
September 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28868627/hydroxyurea-prescription-availability-and-use-for-children-with-sickle-cell-disease-in-italy-results-of-a-national-multicenter-survey
#20
Raffaella Colombatti, Giovanni Palazzi, Nicoletta Masera, Lucia Dora Notarangelo, Elisa Bonetti, Piera Samperi, Angelica Barone, Silverio Perrotta, Elena Facchini, Maurizio Miano, Giovanni Carlo Del Vecchio, Maria Elena Guerzoni, Paola Corti, Federica Menzato, Simone Cesaro, Maddalena Casale, Paolo Rigano, Gian Luca Forni, Giovanna Russo, Laura Sainati
BACKGROUND: The number of patients with sickle cell disease (SCD) has increased in Italy in the past decade due to immigration. In spite of the established efficacy of hydroxyurea (HU) in childhood, population-based data regarding its prescription and effectiveness come mainly from studies performed in adults or outside Europe. POPULATION AND METHODS: The Hydroxyurea in SCD: A Large Nation-wide Cohort Study from Italy was a retrospective cohort study of adult and pediatric patients with SCD attending 32 centers...
September 4, 2017: Pediatric Blood & Cancer
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