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“Acute chest pain”

Hsing-Lin LinMD, Yih-Wen Tarng, Tung-Ho WuMD, Fong-Dee Huang, Wen-Yen Huang, Yi-Pin ChouMD
BACKGROUND: Serious blunt chest trauma usually induces hemothorax, pneumothorax, and rib fracture. Early video-assisted thoracoscopic surgery (VATS) to evacuate retained hemothorax is one commonly used treatment. In this study, a new strategy was implemented to combine VATS with fractured rib fixation simultaneously. METHODS: This prospective observational study was performed from January 2013 to April 2018. All patients were aged 18 years or older and had blunt chest trauma with displaced fractures in more than three ribs...
March 13, 2019: International Journal of Surgery
Catarina Perez-Brandão, Conceição Trigo, Fátima F Pinto
INTRODUCTION: Pericarditis is an inflammation of the pericardium. It may be infectious or secondary to a systemic disease. The aim of this study was to analyze the clinical findings, course, treatment and follow-up of children diagnosed with pericarditis at our center. METHODS: We performed a retrospective analysis of all children admitted to our pediatric cardiology unit with pericarditis between 2003 and 2015. Patient characteristics were summarized using frequencies and percentages for categorical variables and medians with percentiles for continuous variables...
March 12, 2019: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Nihar R Desai, Jacob A Udell, Yongfei Wang, Erica S Spatz, Kumar Dharmarajan, Tariq Ahmad, Howard M Julien, Amarnath Annapureddy, Abhinav Goyal, James A de Lemos, Frederick A Masoudi, Deepak L Bhatt, Karl E Minges, Harlan M Krumholz, Jeptha P Curtis
Background Despite improvements on individual process of care measures for acute myocardial infarction (AMI), little is known about performance on a composite measure of AMI care that assesses the delivery of many components of high-quality AMI care. We sought to examine trends in patient- and hospital-level performance on a composite defect-free care measure, identify disparities in the performance across sociodemographic groups, and identify opportunities to further improve quality and outcomes. Methods and Results We calculated the proportion of patients in the National Cardiovascular Data Registry-Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines (now known as the Chest Pain - Myocardial Infarction Registry) between January 1, 2010, and December 31, 2017, receiving defect-free AMI care including guideline-recommended pharmacotherapy, timely provision of medical and reperfusion therapy, assessment of ventricular function, referral to cardiac rehabilitation, and smoking cessation counseling for patients with AMI...
March 2019: Circulation. Cardiovascular Quality and Outcomes
Weiwei Xu, He Zou, Shiwei Huang
A 54-year-old man presented to the emergency department with chest pain and electrocardiogram (ECG) changes of acute ST-segment elevation myocardial infarction (STEMI) and junctional ST-depression with tall symmetrical T-waves (de Winter T-wave) in the lateral and inferior leads. Emergent coronary angiography revealed a culprit lesion in the gigantic obtuse marginal artery (OM). This case demonstrates the de Winter T-wave can occur in a patient with an acute occlusion of OM. Emergency physicians, ambulance staff, cardiologists and all involved in STEMI networks should familiarize themselves with this unusual ECG pattern and consider transferring patients for urgent angiography and reperfusion therapy...
March 7, 2019: Journal of Electrocardiology
Kathryn King-Shier, Hude Quan, M K Kapral, Ross Tsuyuki, Libin An, Suvro Banerjee, Danielle A Southern, Nadia Khan
OBJECTIVES: Successful treatment of acute coronary syndrome (ACS) relies on its rapid recognition. It is unclear whether the accepted presentation of chest pain applies to different ethnic groups. We thus examined potential ethnic variations in ACS symptoms and clinical care outcomes in white, South Asian and Chinese patients. DESIGN: Cross-sectional survey. SETTING: Participants were hospitalised at 1 of 12 Canadian centres across four provinces...
March 13, 2019: BMJ Open
Felix Mwembi Oindi, Evan Sequeira, Herman Ryan Sequeira, Steve Kyende Mutiso
BACKGROUND: Takotsubo cardiomyopathy is rare in pregnancy and is characterized by left ventricular dysfunction with apical ballooning. This transient cardiac dysfunction may affect women of childbearing age in the antepartum, intrapartum or postpartum period. Most patients respond well to medical management with resolution of cardiac dysfunction within weeks. CASE PRESENTATION: A 35-year-old female in her second pregnancy presented with severe preeclampsia at 31 weeks of gestation...
March 12, 2019: BMC Pregnancy and Childbirth
Jidong Liu, Ye Liu, Wengang Yang, Jianmin Gu, Song Xue
Background: The aim of this study is to evaluate the five-year outcomes after thoracic endovascular aortic repair (TEVAR) of symptomatic Stanford type B penetrating aortic ulcer (PAU) associated with intramural hematoma (IMH) in Chinese patients. Methods: From January 2009 to April 2013, 118 patients with typical severe acute chest pain were diagnosed with Stanford type B acute aortic syndrome (AAS) in our department and received TEVAR. Within the group, 28 patients were diagnosed with PAU associated with IMH by computed tomography angiography (CTA) and subsequently evaluated with repeated CTA...
January 2019: Journal of Thoracic Disease
Takuya Watanabe, Ichiro Fukai, Katsuhiro Okuda, Satoru Moriyama, Hiroshi Haneda, Osamu Kawano, Keisuke Yokota, Masayuki Shitara, Tsutomu Tatematsu, Tadashi Sakane, Risa Oda, Ryoichi Nakanishi
Background: We herein report the usefulness of two types of talc pleurodesis for secondary pneumothorax of elderly patients with persistent air leak who have severe pulmonary emphysema. Methods: We assessed 17 elderly patients with persistent air leak who received talc pleurodesis for secondary pneumothorax from April 2013 to March 2017. Thoracoscopic talc poudrage (TTP) (n=11) was performed in patients whose general condition was thought to sufficiently stable to tolerate for general anesthesia...
January 2019: Journal of Thoracic Disease
Stephen E Attwood
Eosinophilic oesophagitis is a disease that has been recognized in the past 30 years. It causes dysphagia and other symptoms of oesophageal dysfunction. Eosinophilic oesophagitis presents either with a chronic feeling of difficulty swallowing, with food moving slowly through the oesophagus, or as an acute food bolus obstruction requiring emergency attention. Patients may also experience chest pain at this time. It is an inflammatory disorder, thought to be driven by food or environmental antigens, where the most distinctive cell type is eosinophils...
March 2, 2019: British Journal of Hospital Medicine
Runcheng He, Qing Huang, Xinxiang Yan, Yunhai Liu, Jie Yang, Xiaobin Chen
We report a case of a 66-year-old female who burst into flaccid paralysis of the lower extremities, accompanied by loss of pain and temperature sensation below T4 level, during an oxygen-ozone injection for disc herniation. Half an hour later, she suffered from chest pain. Magnetic resonance imaging (MRI) showed long segment hyperintensity in the thoracic spinal cord from T2 to 10 level on sagittal T2-weighted images (T2WI). The electrocardiogram (ECG) showed ST-segment elevation in V1-V6 leads. She was diagnosed with spinal cord infarction and ST-elevation myocardial infarction (STEMI)...
2019: Frontiers in Neurology
Sabine Szunerits, Vladyslav Mishyn, Iwona Grabowska, Rabah Boukherroub
Cardiovascular diseases (CVD) remain the leading cause of death within industrialized nations as well as an increasing cause of mortality and morbidity in many developing countries. Smoking, alcohol consumption and increased level of blood cholesterol are the main CVD risk factors. Other factors, such as the prevalence of overweight/obesity and diabetes, have increased considerably in recent decades and are indirect causes of CVD. Among CVDs, the acute coronary syndrome (ACS) represents the most common cause of emergency hospital admission...
February 19, 2019: Biosensors & Bioelectronics
Hugo R Ramos, Luis E López, Walter Quiroga Castro, César Mj Serra
Cardiac troponins are pivotal in the evaluation of patients who suffer from acute chest pain, and the introduction of the High-Sensitivity Cardiac Troponins (hs-cTn) has shown that there are differences between male and female patients. Recent recommendations from experts point out that an appropriate evaluation must take into account the patients' sex, but there is no clear evidence of the implementation of this recommendation in the clinical practice, and the matter has sparked controversy. If the same cut-off value is used for both sexes, myocardial infarction in men might be overdiagnosed, especially in the elderly, who have relatively higher values, and might be underdiagnosed in most women...
March 6, 2019: Hellenic Journal of Cardiology: HJC
Preethi Ramachandran, Fady Farag, Rewais Morcus, Vladimir Gotlieb
BACKGROUND Autoimmune heparin-induced thrombocytopenia (aHIT) refers to a condition, in which antiplatelet factor-4 (PF4) antibodies activate platelets even in the absence of heparin (heparin independent platelet activation). This is a severe hypercoagulable state triggering massive thrombin storm needing additional therapies and aggressive anticoagulation apart from stopping heparin. Thrombocytopenia in these cases seems to be very severe and prolonged compared to classic HIT and poses additional clinical challenges in terms of anticoagulation management...
March 9, 2019: American Journal of Case Reports
Nicholas McNamara, Abdalla Ibrahim, Zahir Satti, Munir Ibrahim, Thomas J Kiernan
This review examined the relevance of chest pain, pericardial friction rub, pericardial effusion and ECG changes in regard to the diagnosis of acute pericarditis. It also assessed the evidence for the management and therapeutic guidelines, specifically nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine and corticosteroids. Overall, there appears to be a lack of research into pericarditis. The bulk of high-quality research seems to have been carried out prior to the publication of the European Society of Cardiology guidelines of 2015...
March 8, 2019: Future Cardiology
X F Li, W Xi, Y Y Wang, X Q Wang, N Zhao, H J Wang, T Wu, J C Yang, G L Zhang, L Y Zhang, J L Zhao, A L Yang, Y Y Ning, Y N Liu, J Ping, Z C Gao, Y G Tong, G Z Tian
Objective: To better understand the clinical features of human adenovirus type 7 (hAdV7) pneumonia and to identify whether there is a variation in the genome of the strain (CHN/BeiJing/2018) isolated during the small-scale epidemic. Method: Forty-two patients were diagnosed with hAdV7 pneumonia between October 27th, 2017 and February 28th, 2018. They were all males with an average age of (21±2) years. Demographic and clinical data were reviewed and analyzed in detail. The nucleic acid of the epidemic strain was extracted from a bronchoalveolar lavage fluid sample...
March 12, 2019: Chinese Journal of Tuberculosis and Respiratory Diseases
Tomoki Iemura, Chihiro Mano, Akifumi Oba, Norihiro Kawabata, Yoshihito Horisawa, Masashi Matsui, Yasuko Miyahara, Mitsuru Itoh
A 64-year-old man presented to the emergency department with sudden-onset upper abdominal pain and pain in the left chest area. His platelet count was 121.7×104 /µl. Computed tomography (CT) showed bilateral adrenal swelling and inflammation of the adjacent tissue. Diffusion-weighted magnetic resonance imaging (MRI) showed hyperintensity in the bilateral adrenal glands. The patient was diagnosed with bilateral adrenal infarction. A bone marrow biopsy yielded a diagnosis of essential thrombocythemia, and a positive JAK2 V617F mutation was detected...
2019: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
W L Wagner, A Rothermel, T Mokry, C Sommerer, C P Heußel, H-U Kauczor
No abstract text is available yet for this article.
March 6, 2019: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Alison M Whitehead, Nancy H Maher, Karen Goldstein, Bevanne Bean-Mayberry, Claire Duvernoy, Melinda Davis, Basmah Safdar, Fay Saechao, Jimmy Lee, Susan M Frayne, Sally G Haskell
BACKGROUND: In the U.S. civilian population, sex differences have been identified in cardiovascular health; these differences have been used to inform care. Our objective is to determine if the same sex differences are present in Veterans who use the Department of Veterans Affairs (VA) Health Care System given the additional stressors associated with military service. METHODS: Cardiovascular disease (CVD) risk factors and conditions among women and men Veterans using VA in fiscal year (FY) 2014 were identified through the presence of International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes in VA administrative records...
March 6, 2019: Journal of Women's Health
Yunus Çolak, Shoaib Afzal, Peter Lange, Lars C Laursen, Børge G Nordestgaard, Morten Dahl
BACKGROUND: Cough is a well-recognized symptom in asthma, but the role and impact of chronic cough in individuals with asthma has not been described in the general population. OBJECTIVE: We hypothesized that among individuals with asthma, those with chronic cough versus those without have a more severe disease phenotype. METHODS: We identified individuals with asthma and chronic cough among 14,740 adults from the Copenhagen General Population Study, and investigated respiratory symptoms, healthcare utilizations, lung function, and biomarkers in blood...
March 2, 2019: Journal of Allergy and Clinical Immunology in Practice
Manuel R Cervetti, Mariano Camporrotondo, Paz Ricapito, Juan C Espinoza, Fernando Piccinini, Mariano Vrancic, Daniel Navia
A 67-year-old man presented with chest pain. Clinical examination revealed hypertension (160/90 mm Hg). Electrocardiogram indicated no acute coronary syndrome and cardiac enzymes were normal. Catheterization was performed owing to the patient's continuing chest pain and ascending aortogram revealed irregular aortic wall. A computed tomography image showed the shape of penetrating ulcer. The patient was taken to the operating room and intraoperative examination confirmed the diagnosis of penetrating atherosclerotic ulcer (PAU)...
March 5, 2019: Journal of Cardiac Surgery
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