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Rodríguez-González Fayna - - 2010
Cardiac contusion, usually caused by blunt chest trauma, has been recognized with increased frequency over the past decades. Traffic accidents are the most frequent cause of cardiac contusions resulting from a direct blow to the chest. Other causes of blunt cardiac injury are numerous and include violent fall impacts, interpersonal ...
Tatham K - - 2010
The incidence of myocardial ischaemia is increasing in the obstetric population. This has been attributed to several factors including greater maternal age, the increasing incidence of obesity and diabetes, and the growing population of patients with grown-up congenital heart disease who now reach adulthood and become pregnant. A number of ...
Bektas Firat F Department of Emergency Medicine, Akdeniz University Faculty of Medicine, Antalya, - - 2011
Procalcitonin is a calcitonin precursor that is used as an inflammatory biomarker in the plasma of patients with sepsis. The aim of this study was to determine the diagnostic accuracy of emergency department (ED) point-of-care blood procalcitonin testing in identifying myocardial infarction (MI) in patients with chest pain of presumed ...
Backus Barbra E - - 2010
Decision-making in chest pain patients is hampered by poor diagnostic power of patient's history, electrocardiogram, age, risk factors, and troponin. Each of these findings may be qualified with 0, 1, or 2 points. Together they compose the HEART score. We tested the hypothesis that the HEART score predicts major adverse ...
Gadhinglajkar Shrinivas - - 2010
Sporadic reports on cardiac herniation are available in the literature; most of them had followed intrapericardial pneumonectomies for malignant pulmonary tumors. We present an uncommon event of heart herniation after a completion pneumonectomy indicated for chronic bronchiectasis. A 35-year-old male patient was operated for left completion pneumonectomy. A 6 cm ...
Mahmod Masliza - - 2010
Traumatic coronary artery dissection is a very rare cause of myocardial infarction. Occurrence of this condition late in the posttraumatic period is extremely uncommon. We present a case of a young patient with acute myocardial infarction 4 weeks after blunt chest trauma. Coronary angiography showed left anterior descending artery dissection ...
Al-Githmi Iskander - - 2010
Primary cardiac paraganglioma (pheochromocytoma) is very rare, constituting only 1% of cardiac tumours. A case of a 44-year-old woman presenting with angina chest pain and a tumour with dual blood supply from both the right and left coronary arteries is reported.
Pyxaras Stylianos A - - 2010
A 59-year-old male patient affected by pleural mesothelioma presented with chest pain and localized ST elevation in the electrocardiogram. Urgent coronary angiography excluded an acute coronary occlusion, whereas high-resolution computed tomography of the chest revealed tumor infiltration and associated acute inflammation of the pericardial sac. This case illustrates how initial ...
Yanagawa Youichi - - 2012
Pharyngeal pain alone due to acute myocardial infarction is rare. A 37-year-old man felt sudden pharyngeal pain. He was transferred to a medical facility under a misdiagnosis of pharyngitis. However, he was thereafter found to have acute myocardial infarction and thus was transferred to another hospital. An emergency coronary angiogram ...
Tobin Kenneth J - - 2010
Coronary artery disease is the leading cause of death in the United States. The combination of noninvasive cardiovascular testing and invasive cardiac procedures accounts for a substantial portion of the yearly healthcare expenditure in the United States. Although the diagnosis of ischemically-driven chest pain may appear to be simple and ...
Haron Hairufaizi - - 2010
An injury to the left ventricle after a chest tube insertion is a rare but lethal phenomenon that is likely to occur if precautions are not seriously addressed. We present a 15-year-old girl who was diagnosed a left empyema thoracis. An attempt to place a chest drain in this young ...
Song Li - - 2010
Delay in seeking medical care in patients with acute myocardial infarction (AMI) is receiving increasing attention. This study aimed to examine the association between expected symptoms and experienced symptoms of AMI and its effects on care-seeking behaviors of patients with AMI. Between November 1, 2005 and December 31, 2006, a ...
Ginghina Carmen - - 2010
It is frequently recognized in medical literature as well as in daily clinical practice that right ventricular myocardial infarction and pulmonary embolism are two of the most challenging clinical pictures to differentiate in cardiology and the treatment, often chosen upon a mixture of clinical suspicion criteria subsequently confirmed by other ...
Venugopal S - - 2010
Intratesticular lesions identified on ultrasound are usually malignant. It presents a particular dilemma to the surgeon when conservative approach is considered. A 55-year-old smoker with peripheral vascular disease had attended the accident and emergency with acute left hemiscrotal pain of 24-h duration. Clinical examination revealed a swollen, tender hemiscrotum. Ultrasound ...
Akhtar Mohammed Majid - - 2010
Acute coronary syndrome (ACS), encompassing unstable angina (UA), non-ST elevation myocardial infarction (NSTEMI) and ST elevation myocardial infarction (STEMI), is often the result of an acute thrombotic occlusion of the coronary vessels, associated with atheromatous plaque rupture or erosion. ACS is associated with a severely impaired prognosis and requires prompt ...
Naunheim Rosanne S - - 2010
Controversy exists concerning the lethality of Tasers. These are conducted electrical weapons which incapacitate subjects by delivering an electrical charge that causes diffuse muscle contraction. In North America, over 440 deaths have been reported immediately following Taser use. Taser International has recently suggested that Tasers should not be aimed at ...
Singh Vikas - - 2010
Biomarkers are biological parameters that can be objectively measured and quantified as indicators of normal biologic processes, pathogenic processes, or responses to a therapeutic intervention. Typically thought of as disease process screening, diagnosing, or monitoring tools, biomarkers may also be used to determine disease susceptibility and eligibility for specific therapies. ...
Bösner Stefan - - 2010
To estimate how accurately general practitioners' (GP) assessed the probability of coronary heart disease in patients presenting with chest pain and analyze the patient management decisions taken as a result. During 2005 and 2006, the cross-sectional diagnostic study with a delayed-type reference standard included 74 GPs in the German state ...
Miller Chadwick D CD Department of Emergency Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, - - 2010
We determine whether imaging with cardiac magnetic resonance imaging (MRI) in an observation unit would reduce medical costs among patients with emergent non-low-risk chest pain who otherwise would be managed with an inpatient care strategy. Emergency department patients (n=110) at intermediate or high probability for acute coronary syndrome without electrocardiographic ...
Seneviratne Sujith K - - 2010
The incremental value of regional left ventricular function (LVF) over coronary assessment to detect acute coronary syndrome (ACS) is uncertain. We analyzed 356 patients (mean age, 53+/-12 years; 62% men) with acute chest pain and inconclusive initial emergency department evaluation. Patients underwent 64-slice contrast-enhanced cardiac computed tomography before hospital admission. ...
Najm Hani K - - 2010
Ischemic mitral regurgitation (IMR) results from left ventricular remodelling after myocardial infarction and severely affects cardiovascular mortality and morbidity. Ischemic mitral valve regurgitation also represents a negative prognostic factor for long-term survival in patients undergoing surgical myocardial revascularization. While severe mitral regurgitation should always be corrected during a coronary artery ...
Sanchis Juan - - 2011
Evaluation of chest pain of uncertain origin in the emergency department is a challenge. Chest pain units, involving non-invasive stress testing, have logistic constraints. Our aim was to identify very low risk patients for early discharge using clinical data. A total of 772 patients were studied. Ischemia in the electrocardiogram, ...
Wong Raymond C - - 2010
Conventional emergency department (EMD) approach to triaging acute chest pain syndromes may lead to unnecessary admissions, resulting to in-hospital bed occupancy and increased healthcare costs. We explore the diagnostic utility of early (less than a week) outpatient scheduled single photon emission computed tomography (SPECT) in intermediate-risk chest pain subjects who ...
Solzbach Ulrich - - 2010
Dextrocardia refers to the position of the heart in the right side of the chest. It is a rare clinical phenomenon with a reported incidence of 1 in 5,000-30,000. Although there is a variation in terminology and classification with regard to dextrocardia, the condition of right-sided heart with situs solitus ...
Iversen Kasper K - - 2010
OBJECTIVES: To examine if pregnancy-associated plasma protein-A (PAPP-A) in patients with chest pain, could identify patients at risk for death or myocardial infarction. DESIGN AND METHODS: Patients admitted with chest pain and both normal ECG and normal biomarkers were evaluated by serial measurement of PAPP-A. Main outcome measures were mortality ...
Vandenplas Guy - - 2010
Blunt chest trauma is a rare but known cause of acute coronary lesions. Commonly, the left anterior descending artery is involved which results in an anterior myocardial infarction, diagnosed within a variable time span of 24 hours to 6 months.We report on an unusual case of left main stem occlusion ...
Yousef Yasmin - - 2010
An accessory spleen is present in about 10-30% of the population and, usually, does not cause symptoms. We present a case report of an unusual presentation of accessory spleen infarction, with a literature review. A 12-year old male presented with acute left-upper quadrant pain that slowly resolved. An ultrasound and ...
Overman David M - - 2010
Unbalanced atrioventricular septal defect is an uncommon lesion with widely varying anatomic manifestations. When unbalance is severe, diagnosis and treatment is straightforward, directed toward single-ventricle palliation. Milder forms, however, pose a challenge to current diagnostic and therapeutic approaches. The transition from anatomies that are capable of sustaining biventricular physiology to ...
Laudon Dennis A DA Department of Emergency Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. - - 2010
To determine the long-term outcome of computed tomographic (CT) quantification of coronary artery calcium (CAC) used as a triage tool for patients presenting with chest pain to an emergency department (ED). Patients (men aged 30-62 years and women aged 30-65 years) with chest pain and low-to-moderate probability of coronary artery ...
Januzzi James L JL Jr Massachusetts General Hospital, Boston, MA 02114, - - 2010
For evaluation of patients with chest pain and suspected acute coronary syndrome (ACS), consensus guidelines recommend use of a cardiac troponin cut point that corresponds to the 99 th percentile of a healthy population. Most conventional troponin methods lack sufficient precision at this low level. In a cross-sectional study, 377 ...
Agarwal Megha M Women's Heart Center, Heart Institute, Cedars-Sinai Medical Center, 444 South San Vicente Boulevard, Suite 600, Los Angeles, CA 90048, - - 2010
Anginal chest pain is one of the most common complaints in the outpatient setting. While much of the focus has been on identifying obstructive atherosclerotic coronary artery disease (CAD) as the cause of anginal chest pain, it is clear that microvascular coronary dysfunction (MCD) can also cause anginal chest pain ...
Kim Joonghee - - 2010
To evaluate the safety and efficacy of the computed tomography coronary angiography (CTCA) for evaluation of acute chest pain in real world population, we prospectively enrolled 296 patients with acute chest pain at emergency department (ED) from November 2005 to February 2007. The patients were grouped based on the clinical ...
Hansen Mark - - 2010
The absence of radiological evidence of plaque on computed tomographic coronary angiography (CTCA) reliably excludes obstructive coronary artery disease. We studied patients who presented to our emergency department with chest pain and were admitted to our chest pain assessment service. If they were free of pain and without high-risk features ...
Nabi Faisal - - 2010
STUDY OBJECTIVE: Coronary artery calcium scoring (CACS) is a simple and readily available test for identifying coronary artery disease. Our objective is to evaluate whether a CACS of zero will identify chest pain patients who can be safely discharged home, without need for further cardiac testing. METHODS: This was a ...
Grube Heinrich - - 2010
ACC/AHA guidelines assign a class I indication for use of myocardial perfusion imaging (MPI) for the evaluation of chest pain in patients with acute coronary syndromes and a nondiagnostic ECG. However, MPI is not a widely used modality for the evaluation of patients who present to the ER with chest ...
Bougeard A-M - - 2010
Spontaneous coronary artery dissection (SCAD) is a rare cause of myocardial ischaemia with a high mortality. It most commonly occurs in young women with few risk factors for atherosclerosis. Presentation is varied, from sudden death to chest pain with features of myocardial ischaemia. The case presented highlights the dilemma of ...
Wei Kevin - - 2010
The diagnosis and risk stratification of patients presenting with suspected cardiac chest pain to the emergency department (ED) is difficult, inefficient, and costly. Echocardiography can be used to directly detect myocardial ischemia through the identification of a new wall thickening (WT) abnormality. Contrast echocardiography provides further incremental benefit both for ...
Rajani Ronak - - 2010
We report the case of a 72-year-old lady who presented to our institute with acute pancreatitis. Seven days later, she experienced an acute episode of chest pain associated with the pronounced electrocardiographic changes and elevated cardiac enzymes. Although subsequent coronary angiography was normal, a left ventriculogram demonstrated a marked area ...
Pasian Sergio Giuntini - - 2010
A 49-year-old woman with atypical chest pain was referred for a multidetector computed tomography examination of the coronary arteries after a positive electrocardiography stress test. No coronary atherosclerotic disease was observed on the coronary computed tomography scan. The only findings were 2 side-by-side basal left ventricle diverticula, suggested as a ...
Sidhu Maninder - - 2010
A 2-year-old female child was brought to the emergency department after she was accidentally shot by her father, while cleaning his air rifle loaded with the pointed type 0.22 (5.5 mm) caliber pellet. The pellet hit the front of chest from a distance of about 10-15 m. On physical examination, ...
Garnier Fabien - - 2010
BACKGROUND: Congenital defects of the pericardium are rare and poorly known cardiac malformations. Most of them are left-sided and asymptomatic and are usually incidentally diagnosed. AIMS: To describe the clinical, electrocardiographic, and imaging features of total absence of the left pericardium. METHODS AND RESULTS: We report the cases of 3 ...
Bigalke Boris - - 2010
BACKGROUND: Platelet glycoprotein VI (GPVI) is elevated in patients with acute coronary syndrome (ACS), stroke and associated with acute coronary events. GPVI may be helpful to distinguish an imminent ACS from non-coronary (NC) causes in patients with chest pain who were transferred to chest pain unit, before the myocardial necrosis ...
Michiue Tomomi - - 2010
It is difficult to examine the intact in situ status of thoracic organs, including the heart and lungs, after opening the chest at autopsy. The present study investigated the pathological diagnostic significance of the cardiothoracic ratio (CTR) with regard to heart and lung weight in postmortem plain chest radiography. The ...
Etezadi Vahid - - 2010
We report the application of coronary CT angiogram in urgent assessment of a patient presenting to the emergency department with acute and nonspecific cardiothoracic symptoms.
Wu Cheng-Hsueh - - 2010
Acute myocardial infarction (MI) complicated with acute pancreatitis has been rarely reported. A 68-year-old man presented to our department 15 hours after development of epigastric pain. In addition to his symptoms, the elevated serum pancreatic enzymes and the image study on abdominal computerized tomography all led to the diagnosis of ...
Primetshofer Daniela - - 2010
BACKGROUND: The syndrome of Tako-Tsubo cardiomyopathy (TTC) is characterized by the occurrence of acute chest pain, electrocardiographic signs of ischemia, and transient balloon-like abnormalities in cardiac wall motion mostly involving the left ventricular apex. Significant obstructive coronary artery disease is absent. Owing to its clinical and imaging characteristics, TTC is ...
Gencer Baris - - 2010
BACKGROUND: Chest pain raises concern for the possibility of coronary heart disease. Scoring methods have been developed to identify coronary heart disease in emergency settings, but not in primary care. METHODS: Data were collected from a multicenter Swiss clinical cohort study including 672 consecutive patients with chest pain, who had ...
Kim Jin-Sun - - 2010
We investigated whether ischemia-modified albumin (IMA), a novel biomarker of acute myocardial ischemia, is reliable for diagnosing ischemic chest pain and predicting future cardiac events in clinical practice. We enrolled 390 patients (age 61.7 +/- 39.9 years) who arrived at the emergency department within 6 h of pain onset. We ...
O'Neil Brian - - 2010
Approximately 6 million patients are evaluated annually in US emergency departments for acute chest pain. The delineation of the presence or absence of acute coronary syndromes in these patients must be accurate and efficient in order to prevent missed diagnoses. Coronary computed tomography angiography has great promise as a tool ...
Guarracino F - - 2010
Intraoperative transesophageal echocardiography (iTEE) is widely accepted and routinely used during heart valve surgery. However, the impact of iTEE among patients undergoing coronary artery bypass grafting (CABG) is less well documented. In this study, we aim to define the impact of iTEE in patients undergoing myocardial revascularization for severe coronary ...
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