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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 ...
Yildiz Ahmet - - 2010
A 23-year-old female with the diagnosis of idiopathic thrombocytopenic purpura (ITP) was admitted to our hospital with severe chest pain. The electrocardiogram (ECG) revealed acute anterior myocardial infarction. She underwent an immediate cardiac catheterization. An occluded left anterior descending (LAD) was detected by coronary angiography. Reperfusion was performed successfully by ...
Pezzilli R - - 2010
Acute pancreatitis is a disease initially located into the pancreas that may become a systemic disease involving organs distant from the pancreas. All organs may be involved during an acute attack of pancreatitis: lungs, kidney, heart, liver, brain. The differential is sometime difficult because acute pancreatitis may sometimes mimic an ...
Kralev Stefan - - 2010
The 'pill in the pocket' concept is an established therapy for atrial fibrillation. The current guidelines for the management of patients with ST-elevation myocardial infarction endorse the concept that faster time to reperfusion is associated with important reductions in morbidity and mortality. The mechanical reperfusion and outcome of these patients ...
Comoglio Chiara - - 2010
We describe the case of a 75-year-old man admitted to hospital for chest pain and syncope. Physical examination was normal with evidence of a very small wound on the left chest. Considering the presence of multiple coronary risk factors, an acute coronary syndrome was initially suspected, but the electrocardiogram (EKG) ...
Kunikullaya Kirthana U - - 2010
Irregular and poor quality sleep is common in business process outsourcing (BPO) employees due to continuous shift working. The influence of this on the cardiac autonomic activity was investigated by the spectral analysis of heart rate variability (HRV). 36 night shift BPO employees (working from 22:00 to 06:00h) and 36 ...
Nogueira de Macedo Rafael - - 2009
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome and sudden death. Various therapeutics strategies have been proposed, from conservative management to surgical or percutaneous revascularization. Standard therapy has not been yet established. We report a case of a 34-year-old athlete, presenting chest pain after intense ...
Teh Andrew W - - 2010
Tako-tsubo cardiomyopathy is an increasingly recognised phenomenon characterised by chest pain, ECG abnormalities, cardiac biomarker elevation and transient left ventricular dysfunction without significant coronary artery obstruction. To report the clinical and echocardiographic characteristics from a large single-centre Australian series of patients with Tako-tsubo syndrome. We prospectively collected data on 23 ...
Razdan Rishi - - 2009
We present a case of a 56-year-old white male with a medical history of hypertension,who initially presented with chest pain, diaphoresis, and electrocardiogram (ECG) changes suggesting myocardial infarction. Initial frontal radiograph showed marked displacement of the cardiac silhouette into the left hemithorax. Cardiac catheterization was performed per hospital protocol showing ...
Chinnaiyan Kavitha M - - 2009
In the United States alone, nearly 6 million patients present annually to emergency departments with complaints of chest pain suggestive of acute coronary ischemia. Most of these patients have a non-negligible risk for acute coronary syndrome(s) (ACS) and undergo extended observation and workup for an ischemic cause. Of those admitted ...
Baxt William Gordon - - 2009
The patient was a 55-year-old woman who experienced anterior chest pain after drinking a cup of coffee. The patient had no risk factor for cardiac disease other than mild non- insulin-dependent diabetes mellitus. The patient did have a history of asthma and was on a steroid taper, taking 20 mg ...
Nunes Jos? Pedro L - - 2010
Since the introduction of cardiac plasma troponin measurements, a significant number of patients were seen with chest pain, elevated troponin levels but no significant coronary artery disease. Pulmonary embolism, aortic valve disease, myocarditis, sepsis, trauma, arrythmias, stress cardiomyopathy and dilated cardiomyopathy stand among possible causes for this syndrome. In some ...
Basnet B K - - 2009
Echocardiography is the definitive diagnostic tool for left ventricular systolic dysfunction. But it's expensive and requires trained manpower and thus might not be available in the primary care set up. ECG and Chest X ray, the more basic investigations, may help diagnose LVSD or at least streamline those who absolutely ...
Gumpert Rainer - - 2009
Cardiac luxation after blunt trauma is a rare condition that carries a high mortality rate. We report a case of a left pericardial rupture with partial dislocation of the heart into the left pleural cavity and cardiac strangulation in a polytraumatized patient after a severe motor vehicle accident. This case ...
Phelan Michael P - - 2009
For patients presenting to emergency departments (ED) with a suspected acute coronary syndrome, time of arrival until an electrocardiogram is performed is an important quality metric. In our ED routine quality monitoring found that mean door-to-electrocardiogram (D2ECG) time did not meet our goal and national benchmark of 10 minutes. We ...
Ardhanari Sivakumar - - 2009
A patient with a dualchamber pacemaker with dynamic atrioventricular delay (AVD) experienced acute substernal chest pain. The rhythm strip in the ambulance showed intermittent ST elevation in the inferior leads. An emergent cardiac catheterization revealed nonobstructive coronary artery disease. Rate-responsive dual-chamber pacing with dynamic AVD was responsible for varying devvgrees ...
Cannon Richard O RO - - 2009
Since initial reports over 4 decades ago, cases of patients with angina-like chest pain whose coronary angiograms show no evidence of obstructive coronary artery disease and who have no structural heart disease continue to be a common occurrence for cardiologists. Many features of this patient population have remained constant with ...
Evans William N - - 2010
Dextrocardia is defined by the authors as a right-sided heart with a base-apex axis directed rightward, resulting from a variation in cardiac development, and not used as a general term indicating any heart in the right chest. Dextrocardia occurs in approximately 0.01% of live births and can be discovered in ...
Gupta B K - - 2010
Malaria is a rare cause of splenic infarction. Only a few cases have been reported worldwide, mostly associated with Plasmodium falciparum infection. Here we report a series of four acute malaria patients with splenic infarction, two with P. vivax infection, one with P. falciparum and one with a mixed infection ...
Babu Girish Ganesha - - 2009
Myocardial contusion is a complication of blunt thoracic injuries. Transthoracic echocardiography and electrocardiography (ECG) monitoring are important in suspected cases. We report a 54-year-old man, who sustained a number of injuries including blunt chest injury as a consequence of a road traffic accident. Electrocardiography monitoring over a 48 h period ...
Sentürk T - - 2009
Capecitabine, a fluoropyrimidine derivative, is an orally administered drug that delivers 5-fluorouracil (5-FU) selectively to the tumour. The drug has demonstrated activity in metastatic colorectal cancer. We describe a male patient receiving capecitabine therapy with typical chest pain and electrocardiographic changes consistent with STsegment elevation myocardial infarction. Capecitabine-induced cardiotoxicity may ...
Yaqub Yasir - - 2009
BACKGROUND: Acute cardiac complications occur occasionally during pregnancy and in the immediate postpartum period. Some of these cardiac scenarios are rare and provide a diagnostic challenge. We report a case of apical ballooning syndrome (ABS), also known as takotsubo cardiomyopathy or broken-heart syndrome, in a postpartum patient. CASE: A 32-year-old ...
Siau Keith - - 2011
The association between myocardial infarction and lower limb symptoms is rare and poorly recognised. To our knowledge, we present the third reported case in the English literature of a patient presenting with isolated lower limb pain as the initial symptom of a myocardial infarction. We describe the clinical case and ...
Lim Hong-Kyu - - 2009
A 41-year-old man sought evaluation at the emergency department for pain in the anterior chest that had been ongoing for approximately 35 hours. The electrocardiogram showed marked ST segment elevation in the precordial leads. Cardiac biomarker levels were elevated. He subsequently underwent coronary angioplasty and stenting of the left anterior ...
Murphy J C - - 2009
OBJECTIVE: To assess the aetiology, and prognosis of ST-segment elevation (STE) on the exercise electrocardiogram in patients with chest pain without a prior history of myocardial infarction (MI). METHODS: Between January 1998 and December 2005, 14 941 exercise stress tests were performed to assess chest pain in patients without a ...
Coche Emmanuel - - 2010
To evaluate the feasibility of an automatic, whole-heart segmentation algorithm for measuring global heart function from gated, whole-chest MDCT images. 15 patients with suspicion of PE underwent whole-chest contrast-enhanced MDCT with retrospective ECG synchronization. Two observers computed right and left ventricular functional indices using a semi-manual and an automatic whole-heart ...
Martínez-Sellés Manuel - - 2010
Of a series of 346 consecutive patients with chest pain and no significant coronary stenosis studied with ergonovine provocative test (EPT), 18 fulfilled diagnostic criteria for left ventricular apical ballooning syndrome (LVABS). EPT was negative in all these patients. On the other 328 patients, EPT was positive in 69 (21%). ...
Gaibazzi Nicola - - 2009
AIMS: Safety concerns regarding the use of echo-contrast agents during baseline and SE in patients with recent chest pain have been raised. The purpose of the present study was to provide evidence regarding the safety of flash-replenishment contrast dipyridamole-atropine echocardiography (DASE) in such patients. METHODS AND RESULTS: Five hundred consecutive ...
Mitsos Sofoklis - - 2009
Myocardial ischemia is one of the most extensively studied topics in modern cardiovascular research. Early investigators first reported experimental myocardial ischemia (EMI) in 1862. The open-chest (surgical) approach is a well-developed model of EMI that enables researchers to directly access and observe the heart. With this approach, EMI is generally ...
Anantharam Brijesh - - 2009
Limited studies are available demonstrating the safety of contrast agents in patients undergoing stress echocardiography and none in patients with suspected acute coronary syndrome (ACS). Therefore, we sought to assess the safety profile of contrast agents in patients with stable chest pain and in those with suspected ACS (nondiagnostic electrocardiogram ...
Freitas H F G - - 2011
A 37 year old woman with chest pain was admitted to the emergency room 40 days after normal delivery with ventricular fibrillation due to Takotsubo cardiomyopathy.
Gaibazzi Nicola - - 2009
BACKGROUND: The inappropriate admission of patients with noncardiac chest pain is an enormous cost to society. Myocardial perfusion imaging (MPI) could prove effective in the risk stratification of patients in whom acute coronary syndromes are ruled out by electrocardiography and troponin levels, thanks to its incremental sensitivity beyond that of ...
Odo Takafumi - - 2009
The authors report two cases of acute coronary syndrome diagnosed by diastolic color kinesis imaging (CKI), an echocardiographic technique facilitating regional left ventricular wall motion analysis. Although both patients had experienced chest pain within the previous several days, the pain had remitted prior to visiting the clinic. In addition, neither ...
Dorfman Todd A - - 2009
Regional pericarditis has been described in several settings, but occurs most frequently after transmural myocardial infarction. While the diagnosis remains elusive, it must be considered in all patients with recurrent chest pain following acute myocardial infarction (AMI). Pericarditis classically presents with positional chest pain, a pericardial friction rub, diffuse ST-segment ...
Pezzo Stephanie P - - 2009
Takotsubo cardiomyopathy (TC), or "broken heart syndrome", is an increasingly recognized condition that mimics acute myocardial infarction with morphologically characteristic left ventricular dysfunction in the absence of coronary artery disease. TC is seen almost exclusively in postmenopausal women following extreme emotional or physiologic stress. Although most patients present with chest ...
Antopolsky Meir - - 2009
OBJECTIVE: The aim of this study was to study the clinical presentation of splenic infarction. METHODS: A retrospective examination of files during a 10-year period was conducted. Only computed tomography-proven diagnoses of splenic infarction were included. Signs, symptoms, medical history, and results of investigation were recorded. RESULTS: We found 49 ...
Pfeil Alexander - - 2009
This case report describes cardiac manifestations in a female patient with Churg-Strauss syndrome (CSS). Cardiac magnetic resonance imaging (CMRI) is the only imaging modality able to depict cardiac involvement with endomyocardial fibrosis, myocardial edema, pericarditis associated with pericardial effusions, and apical thrombi in the left or right ventricle. The encasement ...
Hermann Luke K - - 2009
STUDY OBJECTIVE: This is a study designed to evaluate the utility of routine provocative cardiac testing in low-risk young adult (younger than 40 years) patients evaluated for an acute coronary syndrome in an emergency department (ED) setting. METHODS: This was a retrospective observational study of patients aged 23 to 40 ...
de Labriolle Axel - - 2009
Ergot derivatives are frequently administrated during cesarean delivery, induced abortion, or post-partum hemorrhage to promote uterine contractions. Ergot derivatives may also induce coronary spasm and intravenous ergonovine is used in cardiac catheterization laboratories as a diagnostic agent. Serious ischemic cardiac events related to ergonovine are rare and have most often ...
Oghlakian Gerard - - 2010
Cardiac complications of chest trauma range from arrhythmias to valvular avulsions to myocardial contusion, rupture, and rarely myocardial infarction. We describe a case of a young patient with blunt chest trauma after a motor vehicle accident in whom the diagnosis of myocardial infarction was established a week later because no ...
Song Ze-Zhou - - 2011
A 88 year-old man admitted with iterative severe chest distress and breathlessness associated with activity without chest complaint for 5 years. He underwent an initial 2DE that did not confirm HVM/NVM and 3DE that strengthened the diagnosis of HVM/NVM. In contrast to 2DE, 3DE provides for pyramid-shaped datasets that encompass the entire ...
Weaver James C - - 2010
Multivessel coronary ventricular fistulae is a rare coronary anomaly whose origin is believed to be from an arterioluminal or arteriosinusoidal connection with the ventricle. The clinical and haemodynamic significance of these fistulae have been a source of controversy despite varying methods of evaluation. A 69 year old female with exertional ...
Vermeltfoort I A C - - 2009
BACKGROUND: A possible link between the heart and brain has been reported for cardiac syndrome X. Anxiety disorder could be a pathophysiological mechanism for this cardiac chest pain. To the authors' knowledge, a quantitative analysis correlating anxiety with the extent of ischemia has not been done. METHODS AND RESULTS: In ...
O'Grady Gregory - - 2009
BACKGROUND: Mortality rates from acute arterial mesenteric ischaemia remain high. Early diagnosis is of prognostic importance; however, early features are often non-specific, necessitating a high index of suspicion and knowledge of the at-risk patient. This study reviewed three decades of fatal cases in Auckland, New Zealand, to identify risk factors ...
Bjørnstad Johannes L - - 2009
Blunt chest trauma might lead to cardiac injury ranging from simple arrhythmias to lethal conditions such as cardiac rupture. We experienced a case of initially overlooked traumatic coronary artery dissection which resulted in acute myocardial infarction (AMI). A high degree of suspicion is needed to diagnose this condition. Based on ...
Vidovich Mladen I - - 2009
Variant (Prinzmetal's) angina is an uncommon cause of precordial pain caused by coronary vasospasm and characterized by transient ST elevation and negative markers of myocardial necrosis. This is the case of a female patient with a prior history of depression and panic attacks who presented with recurrent symptoms including chest ...
Ulriksen Line Skjold - - 2009
OBJECTIVE: The purpose of this study was to assess the prognostic effect of flow-mediated dilatation (FMD) in patients with chest pain admitted to a coronary care unit. METHODS: Endothelium-dependent FMD in the brachial artery was examined in 223 patients with acute chest pain. All patients underwent a stress test at ...
Gundersen Kenneth - - 2009
BACKGROUND: One of the factors that limits survival from out-of-hospital cardiac arrest is the interruption of chest compressions. During ventricular fibrillation and tachycardia the electrocardiogram reflects the probability of return of spontaneous circulation associated with defibrillation. We have used this in the current study to quantify in detail the effects ...
Baccouche Hannibal - - 2009
Cardiac injury occasionally occurs as a result of blunt chest trauma. Most cardiac complications in chest trauma are due to myocardial contusion rather than direct damage to the coronary arteries. However, traumatic coronary injury has been reported, and a variety of underlying pathophysiological mechanisms have been proposed. We present a ...
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