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https://www.readbyqxmd.com/read/28730895/incidence-treatment-strategies-and-outcomes-of-acute-coronary-syndrome-with-and-without-ongoing-myocardial-ischaemia-results-from-the-czech-3-registry
#1
Petr Tousek, Klara Staskova, Anna Mala, Martin Sluka, Alexandra Vodzinska, Radek Jancar, Denisa Maluskova, Jiri Jarkovsky, Petr Widimsky
BACKGROUND: Patients with acute coronary syndrome with signs of ongoing myocardial ischaemia at first medical contact should be indicated for immediate invasive treatment. AIM: To assess the incidence, treatment strategies and outcomes of acute coronary syndrome in a large unselected cohort of patients with respect to the signs of ongoing myocardial ischaemia. METHODS: The CZECH-3 registry included 1754 consecutive patients admitted for suspected acute coronary syndrome to 43 hospitals during a 2-month period in the autumn of 2015...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28730876/epipericardial-fat-necrosis-an-atypical-cause-of-acute-chest-pain
#2
Luis Enrique Lezcano Gort, Imara Herrera Denis, María José Romero Castro, Zineb Kounka, David Chipayo Gonzales, José Javier Gómez Barrado
No abstract text is available yet for this article.
July 21, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28728745/early-readmissions-after-acute-myocardial-infarction
#3
Chun Shing Kwok, Chun Wai Wong, Hannah Shufflebotham, Luke Brindley, Tamseel Fatima, Adrian Shufflebotham, Diane Barker, Ashish Pawala, Grant Heatlie, Mamas A Mamas
This study aims to evaluate the rate, predictors, and causes of 30-day readmissions in a single tertiary hospital in the United Kingdom. We conducted a retrospective study of all patients admitted between 2012 and 2014 with a diagnosis of acute myocardial infarction, who were in the Myocardial Infarction National Audit Project register. Data on patient demographics, comorbidities, care received, and in-hospital mortality were collected. Rates of 30-day readmission and causes of readmission were evaluated. Univariate and multiple logistic regressions were used to identify predictors of all-cause, cardiac, and noncardiac readmission...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28728608/influence-of-apelin-12-on-troponin-levels-and-the-rate-of-mace-in-stemi-patients
#4
Xhevdet Krasniqi, Blerim Berisha, Masar Gashi, Dardan Koçinaj, Fisnik Jashari, Josip Vincelj
BACKGROUND: During acute myocardial infarction, phosphorylated TnI levels, Ca(2+) sensitivity and ATPase activity are decreased in the myocardium, and the subsequent elevation in Ca(2+) levels activates protease I (caplain I), leading to the proteolytic degradation of troponins. Concurrently, the levels of apelin and APJ expression are increased by limiting myocardial injury. METHODS: In this prospective observational study, 100 consecutive patients with ST-elevation acute myocardial infarction were included...
July 20, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28723703/management-of-chest-pain-in-the-french-emergency-healthcare-system-the-prospective-observational-epidoultho-study
#5
Sandrine Charpentier, Sebastien Beaune, Luc Marie Joly, Abdo Khoury, François-Xavier Duchateau, Raphael Briot, Bertrand Renaud, François-Xavier Ageron
OBJECTIVE: The aim of this paper was to describe the epidemiology, and diagnostic and therapeutic strategies that emergency physicians use to manage patients presenting with chest pain at all three levels of the French emergency medical system - that is, dispatch centres (SAMUs: the medical emergency system), which operate the mobile intensive care units (MICUs), and hospitals' emergency departments (EDs), with a focus on acute coronary syndrome (ACS). PATIENTS AND METHODS: All patients with chest pain who contacted a SAMU and/or were managed by a MICU and/or were admitted into an ED were included in a 1-day multicentre prospective study carried out in January 2013...
July 18, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28720694/myocardial-infarction-masquerading-as-myocarditis-in-a-patient-with-factor-v-leiden-unmasked-with-mr
#6
Jason Leo Walsh, Benjamin Howell Lole Harris, Walid Gharzuddine, Hussain Isma'eel
We present a case of a 21-year-old man presenting with sharp left-sided chest pain. A CT pulmonary angiogram was negative, ECG was unremarkable and a mild troponin rise was observed. Myocarditis was suspected as the most likely diagnosis, particularly in view of the patient's previous diagnosis of myocarditis 3 years prior. A cardiac MRI was indicative of an acute mid-anterior myocardial infarction (MI) and an old inferior MI with an associated aneurysm. A subsequent angiogram revealed a subtotal occlusion in the second diagonal artery, likely precipitated by homozygous factor V Leiden...
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28720601/a-case-of-progressive-orthopnoea-and-shoulder-pain-secondary-to-bilateral-diaphragmatic-paralysis
#7
Anna Herbert, Waseem Asrar Khan, Salem Madi
A 45-year-old man with a raised body mass index presented with an acute history of right lower chest pain and increasing breathlessness. C reactive protein, D dimer and cardiac echocardiography were negative, with mild bibasal atelectasis the only positive reported finding from erect chest X-ray and CT pulmonary angiogram. He was discharged with antibiotics for a chest infection. He remained severely breathless and was referred to the sleep-related breathing disorders clinic. He described shoulder pain, daytime tiredness and sleeping upright due to a ââ'¬Ëœsuffocatingââ'¬â"¢ sensation...
July 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28718268/oxymorphone-induced-thrombotic-microangiopathy-mimicking-atypical-haemolytic-uremic-syndrome
#8
Amibhen Gandhi, Saad Ullah, Shani Kotadia, Samer Nasser
Atypical Haemolytic Uremic Syndrome (aHUS) is a rare life threatening entity characterized by thrombocytopenia, haemolytic anaemia and renal dysfunction. It is a thrombotic microangiopathy related to genetic mutations in the alternate complement pathway and has a distinct pathophysiology which makes it harder to distinguish from other microangiopathies. We present a case of a 25-year-old male patient with history of polysubstance abuse who presented with chest pain and dyspnoea. He admitted to using injectable oxymorphone (Opana) two weeks before presentation...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28717781/spinal-cord-infarction-mimicking-ischemic-heart-disease
#9
Dae Won Lee, Yoon Hee Choi
Spinal cord infarction is a rare condition and is easily misdiagnosed owing to its initial non-specific manifestation. We report a case of a 77-year-old man who presented with chest pain and upper back pain initially, and was misdiagnosed with a myocardial infarction. Four hours after admission, he complained of numbness in his entire left leg below the knee, with rapid deterioration of neurological symptoms. After 9 hours, loss of sensation progressed up to the T4 dermatome, strength of both lower extremities deteriorated to grade 0, and decrease in anal tone and deep tendon reflex was observed...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28716302/acute-chest-pain-in-an-anxious-woman
#10
Ginna Alexandra Polania-Zuleta, Fabio Suescun-Calderon, Juan Urbano
No abstract text is available yet for this article.
July 14, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28713853/factors-associated-with-acute-postoperative-pain-following-breast-reconstruction
#11
Anita R Kulkarni, Andrea L Pusic, Jennifer B Hamill, Hyungjin M Kim, Ji Qi, Edwin G Wilkins, Randy S Roth
INTRODUCTION: Post-mastectomy breast reconstruction has become an increasingly important component of breast cancer treatment. Unfortunately, some patients experience severe postoperative pain, placing them at risk for increased clinical morbidity and the development of disabling chronic pain. In an attempt to identify at-risk patients, we prospectively evaluated patient characteristics and medical/surgical variables associated with more severe acute post-reconstruction pain. METHODS: Women (N = 2207; one-week 82...
March 2017: JPRAS Open
https://www.readbyqxmd.com/read/28712683/-stratification-of-thoracic-pain-with-modified-heart-score-and-its-relationship-to-short-term-cardiovascular-events
#12
Manuel Chacón-Diaz, Jorge Salinas, Rafael Doig
OBJECTIVE: Chest pain is a major reason for emergency room care worldwide. The relationship between the Modified Heart Score and the presence of major cardiac events at 30 days after emergency admission was evaluated. METHODS: Retrospective, observational study in a single center. In patients older than 18 years old, who were treated for chest pain, in whom the Modified HEART Score was applied at admission and related to the presence of major cardiac events (myocardial infarction, death, hospitalization due to cardiac causes and percutaneous coronary revascularization Or surgical) at 30 days of follow-up...
July 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28712194/blocked-coronary-artery-due-to-coronary-spasm-treated-with-stent-insertion-a-sub-optimal-result
#13
Habib Rehman Khan, Sajid Aslam
Myocardial infarction (MI) is an extremely common cause of chest pain. MI can be acute with ST elevation (STEMI) or non-STEMI (NSTEMI). Coronary artery spasm can be severe enough to cause occlusion of the coronary arteries particularly with an exaggerated response in regions of coronary atheroma and plaque ulceration. It is not uncommon for coronary spasm to be mistaken with acute thrombotic occlusion of the coronary artery. We describe a case of a 42-year old man with known cardiac risk factors presents with chest pain for few hours to a tertiary centre hospital...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28712187/utility-of-heart-type-fatty-acid-binding-protein-h-fabp-point-of-care-test-in-the-early-hours-of-stemi-compared-with-troponin-i-in-pakistani-population
#14
Walid Ahmad Abbasi, Muhammad Saleem, Shahid Rasheed, Azhar Mahmood Kiyani
BACKGROUND: Acute coronary syndrome remains a dominant cause of high morbidity and mortality despite advancements in treatment This study was conducted to examine the utility of point-of-care test of heart-type fatty-acid binding protein (h-FABP) and compare it with the point-of-care test of cardiac troponin I (cTnI) in the first 06 hours of STEMI. METHODS: This cross-sectional, comparative study which was conducted in Rawalpindi institute of cardiology, Rawalpindi, Pakistan, from January to June 2015...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28711124/cardiovascular-conditions-in-the-observation-unit-beyond-chest-pain
#15
REVIEW
Jeremiah D Gaddy, Kathleen T P Davenport, Brian C Hiestand
The first emergency department observation units (EDOUs) focused on chest pain and potential acute coronary syndromes. However, most EDOUs now cover multiple other conditions that lend themselves to protocolized, aggressive diagnostic and therapeutic regimens. In this article, the authors discuss the management of 4 cardiovascular conditions that have been successfully deployed in EDOUs around the country.
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28711123/care-of-the-patient-with-chest-pain-in-the-observation-unit
#16
REVIEW
Joseph B Borawski, Louis G Graff, Alexander T Limkakeng
Care of the patient presenting to an emergency department (ED) with chest pain remains a common yet challenging aspect of emergency medicine. Acute coronary syndrome presents in nonspecific fashion. The development and evolution of the ED-based observation unit has helped to safely assess and diagnose those most at risk for an adverse cardiac event. Furthermore, there are several provocative testing modalities to help assess for coronary artery disease. This article serves to describe and discuss the modern ED-based observation unit approach to patients with chest pain and/or angina equivalents presenting to an ED...
August 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28710886/the-cellular-and-molecular-mechanism-of-radiation-induced-lung-injury
#17
Yijuan Huang, Weiqiang Zhang, Fangrong Yu, Fu Gao
The lung is one of several moderately radiosensitive organs. Radiation-induced lung injury (RILI), including acute radiation pneumonitis and chronic radiation-induced pulmonary fibrosis, occurs most often in radiotherapy of lung cancer, esophageal cancer, and other thoracic cancers. Clinical symptoms of RILI include dry cough, shortness of breath, chest pain, fever, and even severe respiratory failure and death. The occurrence of RILI is a complex process that includes a variety of cellular and molecular interactions which ultimately leads to large fibroblast accumulation, proliferation, and differentiation, resulting in excessive extracellular matrix deposits, causing pulmonary fibrosis...
July 15, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28710245/abciximab-induced-acute-profound-thrombocytopenia-postpercutaneous-coronary-intervention
#18
Todd Golden, Sehem Ghazala, Rita Wadeea, Shilpa Junna
Abciximab (c7E3 Fab) is one of the three potent intravenous glycoprotein IIb/IIIa receptor inhibitors (along with eptifibatide and tirofiban) that have shown significant positive outcomes when used in patients with intracoronary thrombus. However, major side effects have been reported with its use including hypotension, major bleeding and thrombocytopenia. This case is a 53-year-old man presenting with acute chest pain diagnosed with non-ST-elevation myocardial infarction, who underwent percutaneous coronary intervention with abciximab and heparin infusion and developed acute profound thrombocytopenia (platelet count <20,000/L) within 9 hours of infusion...
July 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28701846/rare-presentation-of-congenital-diaphragmatic-hernia-in-a-sexagenarian
#19
C Danny Darlington, G Fatima Shirly Anitha
Congenital diaphragmatic hernia (CDH) usually presents in the neonatal period, and about 10% of reported cases occur in adults. The most common type is Bochdalek's hernia, which occurs through a defect in the posterolateral portion of the diaphragm with an estimated prevalence of 1 in 2500 live births. CDH in adults presents with gastrointestinal or respiratory symptoms, which can be acute or intermittent. We report a case of CDH diagnosed in a 55-year-old man, who presented with acute onset of chest pain and dyspnea with insignificant past history...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28698323/performance-of-highly-sensitive-cardiac-troponin-t-assay-to-detect-ischaemia-at-pet-ct-in-low-risk-patients-with-acute-coronary-syndrome-a-prospective-observational-study
#20
Beata Morawiec, Stephane Fournier, Maxime Tapponnier, John O Prior, Pierre Monney, Vincent Dunet, Nathalie Lauriers, Frederique Recordon, Catalina Trana, Juan-Fernando Iglesias, Damian Kawecki, Olivier Boulat, Daniel Bardy, Sabine Lamsidri, Eric Eeckhout, Olivier Hugli, Olivier Muller
BACKGROUND: Highly sensitive troponin T (hs-TnT) assay has improved clinical decision-making for patients admitted with chest pain. However, this assay's performance in detecting myocardial ischaemia in a lowrisk population has been poorly documented. PURPOSE: To assess hs-TnT assay's performance to detect myocardial ischaemia at positron emission tomography/CT (PET-CT) in low-risk patients admitted with chest pain. METHODS: Patients admitted for chest pain with a nonconclusive ECG and negative standard cardiac troponin T results at admission and after 6 hours were prospectively enrolled...
July 10, 2017: BMJ Open
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