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https://www.readbyqxmd.com/read/28538760/a-multivariate-model-for-prediction-of-obstructive-coronary-disease-in-patients-with-acute-chest-pain-development-and-validation
#1
Luis Cláudio Lemos Correia, Maurício Cerqueira, Manuela Carvalhal, Felipe Ferreira, Guilherme Garcia, André Barcelos da Silva, Nicole de Sá, Fernanda Lopes, Ana Clara Barcelos, Márcia Noya-Rabelo
Background: Currently, there is no validated multivariate model to predict probability of obstructive coronary disease in patients with acute chest pain. Objective: To develop and validate a multivariate model to predict coronary artery disease (CAD) based on variables assessed at admission to the coronary care unit (CCU) due to acute chest pain. Methods: A total of 470 patients were studied, 370 utilized as the derivation sample and the subsequent 100 patients as the validation sample...
April 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28534694/the-heart-score-for-early-rule-out-of-acute-coronary-syndromes-in-the-emergency-department-a-systematic-review-and-meta-analysis
#2
Patricia Van Den Berg, Richard Body
AIMS: The objective of this systematic review was to summarise the current evidence on the diagnostic accuracy of the HEART score for predicting major adverse cardiac events in patients presenting with undifferentiated chest pain to the emergency department. METHODS AND RESULTS: Two investigators independently searched Medline, Embase and Cochrane databases between 2008 and May 2016 identifying eligible studies providing diagnostic accuracy data on the HEART score for predicting major adverse cardiac events as the primary outcome...
May 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28533990/anomalous-origin-of-right-coronary-artery-originating-from-the-pulmonary-trunk-arcapa-an-incidental-finding-in-a-patient-presenting-with-chest-pain
#3
Pragathi Balakrishna, Michael Illovsky, Youssef M Al-Saghir, Abdul M Minhas
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly with an estimated prevalence of 0.002%. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest. We present a case of a 55-year-old female with a history of hypertension who presented to the emergency department with intermittent chest discomfort for three days...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28532506/clinical-evaluation-of-myocardial-involvement-in-acute-myopericarditis-in-young-adults
#4
Ersin Saricam, Yasemin Saglam, Tuncay Hazirolan
BACKGROUND: Myocardial involvement in young adults has various causes. Acute myopericarditis is one of the myocardial involvements in young adults. It is easy to confuse with acute ST-elevation myocardial infarction because of the electrocardiographic features. This study aims to investigate a number of imaging techniques and clinical features for acute myopericarditis in young adults (<30 years of age). METHODS: This retrospective study included 147 patients selected from the 2147 patients at the age of <30 with acute chest pain admitted into emergency service between 2010 and 2016...
May 22, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28532437/management-of-kounis-syndrome-two-case-reports
#5
Majdi Omri, Hajer Kraiem, Olfa Mejri, Mounir Naija, Naoufel Chebili
BACKGROUND: Kounis syndrome corresponds to the occurrence of myocardial injury following an allergic insult. This syndrome is infrequent, and is not well known. In consequence, it is usually misdiagnosed leading to inappropriate treatment. The current literature is limited to case studies and there are no international recommendations concerning this topic. CASE PRESENTATION: We discussed, through two case reports, the clinical presentation and the management of a 60-year-old North African man and a 45-year-old North African man presenting with chest pain suggesting acute coronary syndrome following anaphylactic reaction...
May 23, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28529261/clinical-implications-of-electrocardiograms-for-patients-with-type-a-acute-aortic-dissection
#6
Masami Kosuge, Kazuo Kimura, Keiji Uchida, Munetaka Masuda, Kouichi Tamura
Type A acute aortic dissection (AAD) is a serious cardiovascular emergency requiring urgent surgery. Timely accurate diagnosis is essential, but often challenging, because of the wide spectrum of clinical presentations. In patients with type A AAD, chest pain is the most common symptom; furthermore, ischemic ST-T changes such as ST-segment elevation or depression or negative T waves are frequently observed on presentation ECG. These clinical presentations of type A AAD are difficult to differentiate from those of acute coronary syndrome (ACS), which could lead to delayed diagnosis and treatment of type A AAD or misdiagnosis of ACS followed by inappropriate treatment...
May 19, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28528430/risk-classification-of-highly-sensitive-troponin-i-predict-presence-of-vulnerable-plaque-assessed-by-dual-source-coronary-computed-tomography-angiography
#7
Ting Liu, Guan Wang, Peiling Li, Xu Dai
Patients presenting to the emergency department with acute chest pain, negative conventional troponin and electrocardiogram require serial testing to rule out acute coronary syndrome (ACS). We studied the association of highly sensitive troponin (hsTn) I with vulnerable plaque features as detected by coronary dual source computed tomography angiography (DSCTA) and determined whether hsTn I at the time of presentation combined with early DSCTA could improve classification of patients as high-risk or low risk for ACS...
May 20, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28528054/surgical-management-of-simultaneous-left-coronary-atresia-and-anomalous-right-coronary-artery-origin
#8
Shyam Sathanandam, T K Susheel Kumar, Umar Boston, Christopher J Knott-Craig
A 9-year-old child presented with syncope during exercise. He received a diagnosis of congenital atresia of the left main coronary artery by angiography. He underwent successful coronary artery bypass grafting. On the third postoperative day, he experienced acute, precordial chest pain. An urgent computed tomographic scan showed an unrecognized anomalous origin of the right coronary artery (RCA) with a 1.5-cm intramural course. He was taken back to the operating room to undergo unroofing of the RCA. This case highlights the difficulty involved in making two rare diagnoses that can cause the same exact symptoms in a patient and the surgical challenges associated with it...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28525971/left-ventricular-mural-thrombus-and-dual-coronary-embolization-associated-with-hyperthyroid-cardiomyopathy-and-atrial-fibrillation-a-case-report
#9
Guohui Liu, Ping Yang, Yuquan He
BACKGROUND: The majority of acute myocardial infarction (AMI) events are caused by thrombotic occlusion of the coronary artery, secondary to atherosclerotic plaque erosion or rupture. However, coronary embolism (CE), while rare, is being increasingly recognized as an important cause of AMI. We present the case of a patient with multi-site coronary artery embolization associated with hyperthyroid-related cardiomyopathy and atrial fibrillation. CASE PRESENTATION: A 49-year-old female with a history of hyperthyroidism and atrial fibrillation (AF) was admitted to our hospital presenting with right upper limb pain and swelling...
May 19, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28525723/effectiveness-of-a-decision-aid-in-potentially-vulnerable-patients-a-secondary-analysis-of-the-chest-pain-choice-multicenter-randomized-trial
#10
Kristin L Rising, Judd E Hollander, Jason T Schaffer, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Nilay D Shah, Jonathan Inselman, Jeph Herrin, Victor M Montori, Erik P Hess
BACKGROUND: We test the hypotheses that use of the Chest Pain Choice (CPC) decision aid (DA) would be similarly effective in potentially vulnerable subgroups but increase knowledge more in patients with higher education and trust in physicians more in patients from racial minority groups. METHODS: This was a secondary analysis of a multicenter randomized trial in adults with chest pain potentially due to acute coronary syndrome. The trial compared an intervention group engaged in shared decision making (SDM) using CPC to a control group receiving usual care (UC)...
May 1, 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28522610/a-man-with-chest-pain-and-acute-st-elevations-on-electrocardiogram
#11
Erica O Miller, Vijay K Krishnamoorthy, Frederick S K Ling, Abhishek Chaturvedi, Scott J Cameron
No abstract text is available yet for this article.
May 18, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28522279/-stereotactic-lung-radiotherapy-technical-setting-up-on-novalis-tx-%C3%A2-and-single-centre-prospective-study-of-the-100-first-malignant-pulmonary-nodules-treated-at-centre-jean-perrin
#12
A Bellière-Calandry, G Dupic, F Magnier, V Chassin, V Dedieu, M Lapeyre
PURPOSE: Description of the treatment technique of stereotactic lung radiotherapy on Novalis Tx(®) and prospective study of the first 100 pulmonary nodules treated at centre Jean-Perrin (France). MATERIAL AND METHODS: From October 2012 to December 2015, 100 inoperable pulmonary nodules (62 stage I non-small-cell lung cancer and 38 metastases) of 90 patients with a mean age of 68.2 years (range: 46-89 years) were prospectively treated with dynamic arctherapy on Novalis Tx(®)...
May 15, 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
https://www.readbyqxmd.com/read/28520537/anomalous-origin-of-right-coronary-artery-from-left-coronary-sinus-13-cases-treated-with-the-reimplantation-technique
#13
Alain Cubero, Alejandro Crespo, Gadah Hamzeh, Andrés Cortes, Daniel Rivas, José Ignacio Aramendi
OBJECTIVES: Anomalous aortic origin of a coronary artery is uncommon but potentially clinically significant. Manifestations vary from asymptomatic patients to those who present with angina pectoris, myocardial infarction, heart failure, syncope, arrhythmias, and sudden death. We describe our experience with surgical reimplantation and results at midterm follow-up. METHODS: Between February 2003 and July 2016, a total of 13 patients with anomalous origin of the right coronary artery (RCA) from the left sinus underwent surgical reimplantation...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28516111/transhiatal-herniation-of-the-pancreas-a-rare-cause-of-acute-pancreatitis
#14
Jeremy Wang, Adarsh M Thaker, Wael Noor El-Nachef, Rabindra R Watson
Transhiatal herniation of the pancreas is rare. Acute pancreatitis secondary to this phenomenon is particularly unusual. A 102-year-old woman presented with 1 day of severe chest pain, vomiting, dyspnea, and diaphoresis. Serum lipase was elevated, and computed tomography angiogram of the chest and magnetic resonance cholangiopancreatography revealed a hiatal hernia containing the pancreas, with associated findings of pancreatitis. Pancreatitis in this setting may be due to repetitive trauma or ischemia from sliding, intermittent folding of the pancreatic duct, or pancreatic incarceration...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28515825/late-presentation-of-aortic-aneurysm-and-dissection-following-cardiac-catheterization
#15
Abimbola Shofu, G Mustafa Awan, Bassam Omar, Ghazanfar Qureshi
We report a 63-year-old female with hypertension, hyperlipidemia, and prior pacemaker insertion for atrial fibrillation with symptomatic bradycardia, who was admitted with substernal chest pressure and diaphoresis. Her electrocardiogram revealed atrial fibrillation with demand ventricular pacing and her cardiac biomarkers were negative for acute coronary syndrome. Echocardiogram revealed normal left ventricular systolic function and normal aortic root diameter. Coronary angiography revealed 60-70% obtuse marginal lesion, otherwise mild disease...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515824/cardiogenic-shock-acute-severe-mitral-regurgitation-and-complete-heart-block-after-cavo-tricuspid-isthmus-atrial-flutter-ablation
#16
Thein Tun Aung, Edward Samuel Roberto, Kevin D Kravitz
Radiofrequency (RF) ablation is the first-line management of cavo-tricuspid isthmus dependent atrial flutter. It has been performed with 95% success rate. Adverse events are very rare. We report the first case of acute severe mitral regurgitation (MR) and complete heart block developed after successful atrial flutter ablation. A 62-year-old female with mild MR presented with palpitations. Surface electrocardiogram was suggestive of isthmus dependent atrial flutter. A duodecapolar mapping catheter showed an atrial flutter with cycle length of 280 ms...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28515106/direct-comparison-of-2-rule-out-strategies-for-acute-myocardial-infarction-2-h-accelerated-diagnostic-protocol-vs-2-h-algorithm
#17
Karin Wildi, Louise Cullen, Raphael Twerenbold, Jaimi H Greenslade, William Parsonage, Jasper Boeddinghaus, Thomas Nestelberger, Zaid Sabti, Maria Rubini-Giménez, Christian Puelacher, Janosch Cupa, Lukas Schumacher, Patrick Badertscher, Karin Grimm, Nikola Kozhuharov, Claudia Stelzig, Michael Freese, Katharina Rentsch, Jens Lohrmann, Wanda Kloos, Andreas Buser, Tobias Reichlin, John Pickering, Martin Than, Christian Mueller
BACKGROUND: We compared 2 high-sensitivity cardiac troponin (hs-cTn)-based 2-h strategies in patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED): the 2-h accelerated diagnostic protocol (2h-ADP) combining hs-cTn, electrocardiogram, and a risk score, and the 2-h algorithm exclusively based on hs-cTn concentrations and their absolute changes. METHODS: Analyses were performed in 2 independent diagnostic cohorts [European Advantageous Predictors of Acute Coronary Syndrome Evaluation (APACE) study, Australian-New Zealand 2-h Accelerated Diagnostic Protocol to Assess patients with chest Pain symptoms using contemporary Troponins as the only biomarker (ADAPT) study] employing hs-cTnT (Elecsys) and hs-cTnI (Architect)...
May 17, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28512745/implementation-of-multi-disciplinary-care-reduces-maternal-mortality-in-women-with-sickle-cell-disease-living-in-low-resource-setting
#18
Eugenia Vicky Asare, Edeghonghon Olayemi, Theodore Boafor, Yvonne Dei-Adomakoh, Enoch Mensah, Harriet Ghansah, Yvonne Osei-Bonsu, Selina Crabbe, Latif Musah, Charles Hayfron-Benjamin, Brittany Covert, Adetola A Kassim, Andra James, Mark Rodeghier, Michael R DeBaun, Samuel A Oppong
Sickle cell disease (SCD) is associated with adverse pregnancy outcome. In women with SCD living in low-resource settings, pregnancy is associated with significantly increased maternal and perinatal mortality rates. We tested the hypothesis that implementing a multidisciplinary obstetric and hematology care team in a low-resource setting would significantly reduce maternal and perinatal mortality rates. We conducted a before-and-after study, at the Korle-Bu Teaching Hospital in Accra, Ghana, to evaluate the effect of a multidisciplinary obstetric-hematology care team for women with SCD in a combined SCD-Obstetric Clinic...
May 16, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/28511924/evaluation-of-the-effectiveness-of-a-phone-based-care-coordination-pilot-on-hospital-utilisation-and-costs-for-patients-with-chest-pain
#19
Peita Price, Ruth Vincent, Mark Tacey, Jane Gilchrist, Danny Liew, Leeanne Grigg, Lucio Naccarella
BACKGROUND: A small percentage of the population represents a disproportionate number of attendances at emergency departments (ED). "Frequent presenters" to ED with chest pain do not always fit into established pathways for acute myocardial events. With accelerated "rule out" protocols, patients are often discharged from the Emergency Department (ED) after short lengths of stay. This research will evaluate the effectiveness of a phone based care-coordination pilot designed to meet the needs of patients attending ED with cardiac and non-cardiac chest pain...
April 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28509130/acute-pulmonary-thromboembolism-occurring-during-treatment-with-tolvaptan-in-a-patient-with-autosomal-dominant-polycystic-kidney-disease
#20
Katsuhiko Morimoto, Yasuhiro Akai, Masaru Matsui, Hiroki Yano, Miho Tagawa, Ken-Ichi Samejima, Yoshihiko Saito
Autosomal-dominant polycystic kidney disease (ADPKD) is the most prevalent cystic kidney disease, with approximately half of the patients reaching end-stage renal disease by the age of 60. Tolvaptan prevents renal cyst growth by inhibiting intracellular cyclic AMP and is recommended for patients with ADPKD. Reports of thrombotic complications with tolvaptan have been limited. We report a case of a 60-year-old man who developed thromboembolisms during tolvaptan treatment for ADPKD. The patient started tolvaptan in July 2014...
May 2017: CEN Case Reports
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