Search results for "Chest pain"
showing 10 items of 137 documents
Clinical and Imaging Features of Adults with Recurrent Pulmonary Tuberculosis - A Prospective Case-Controlled Study
2021
Background: Recurrent pulmonary tuberculosis (RPTB) is a growing, important and neglected problem affecting treated TB patients and TB health services across the world, particularly in sub-Saharan Africa. Analyses and identification of differences in clinical features between recurrent PTB and newly diagnosed PTB may lead to improved management recommendations. Methods: Between September 1st 2019 and January 31st 2020, we performed a prospective case controlled study of clinical and imaging features of patients with recurrent pulmonary tuberculosis and compared them with those of newly diagnosed PTB cases. Recurrent PTB was defined as a patient with bacteriologically confirmed active PTB wh…
Diagnostic electrophysiological study in a highly trained young woman with presyncopal symptoms during exercise: a case report
2021
Right ventricular outflow tract (RVOT) ventricular tachycardia (VT) is frequent and occurs in patients without structural heart disease, especially in highly trained athletes. Most of the studies on cardiac adaptations to exercise have been investigated in male athletes. Women, however, are increasingly participating in sports and electrical and structural adaptations in male and female athletes differ significantly. These cardiac adaptations dissimilarities between males and females have potential implications in diagnosing certain types of arrhythmias. We present here a case of a 35-year-old highly-trained woman endurance athlete that attended the clinic complaining about chest pain and d…
Clinical utility of HFABP in myocardial infarction
2018
Assessing chest pain patients presenting to the emergency area (EA) is still a clinical challenge, as acute myocardial infarction (AMI) diagnosis is not adjudicated in the majority of patients. New generation high sensitivity troponin assays (hs-cTn) still present some limitations, thus, novel biomarkers to early rule-in and rule- out myocardial infarction in chest pain patients presenting to the EA are sought after. Among all, heart- type fatty acid binding protein (h-FABP) has been largely investigated. Studies performed on HFABP in these patients present marked heterogeneity. However, it can be stated that HFABP is clearly not a reliable marker for AMI diagnosis, neither as a stand-alone…
Self-referral to chest pain units: results of the German CPU-registry
2012
Chest pain units (CPUs) are increasingly established in emergency cardiology services. With improved visibility of CPUs in the population, patients may refer themselves directly to these units, obviating emergency medical services (EMS). Little is known about characteristics and outcomes of self-referred patients, as compared with those referred by EMS. Therefore, we described self-referral patients enrolled in the CPU-registry of the German Cardiac Society and compared them with those referred by EMS.From 2008 until 2010, the prospective CPU-registry enrolled 11,581 consecutive patients. Of those 3789 (32.7%) were self-referrals (SRs), while 7792 (67.3%) were referred by EMS. SR-patients w…
Valor pronóstico de la troponina T en pacientes hospitalizados con angina o infarto sin elevación del segmento ST
2003
Introduction and objectives. Cardiac troponins are highly specific and sensitive for detecting minimal myocardial damage. The aim of our study was to determine the prognostic value of troponinT levels in patients hospitalized for suspected angina or myocardial infarction without STsegment elevation. Patients and method. We recorded the frequency of death, acute myocardial infarction, heart failure, or need for coronary revascularization in the three months after the onset of symptoms in 346 consecutive patients admitted for suspected acute coronary syndrome, excluding those who developed myocardial infarction with persistent ST-segment elevation. Results. Serum troponin T levels were ≥ 0.1 …
0436: Diagnostic value of serial ultrasensible troponin I measurements for acute coronary syndrome identification in cardiac intensive care unit
2014
Introduction ACS diagnosis relies on the detection of an increase or a decrease in troponin levels (delta-TnI) that might be estimated as absolute (delta-TnI-abs) or relative value (delta-TnI-rel). The discriminative cut-off value of delta-TnI to identify ACS in patients admitted in ICU is a matter of debate. Methods We aimed to determine in a monocentric registry the cut-off value of delta-TnI to identify ACS among patients admitted in ICU with a suspicion of acute myocardial ischemia. All the patients had 2 measurements of ultrasensible cTnI (ADVIA Centaur Siemens®; 99th percentile: 0,04 μg/L). Patients were classified in 4 groups: 1) ACS (NSTEMI, UA), 2) Cardiac non coronary diseases (he…
The Adverse Events and Hemodynamic Effects of Adenosine-Based Cardiac MRI
2011
OBJECTIVE We wanted to prospectively assess the adverse events and hemodynamic effects associated with an intravenous adenosine infusion in patients with suspected or known coronary artery disease and who were undergoing cardiac MRI. MATERIALS AND METHODS One hundred and sixty-eight patients (64 ± 9 years) received adenosine (140 µg/kg/min) during cardiac MRI. Before and during the administration, the heart rate, systemic blood pressure, and oxygen saturation were monitored using a MRI-compatible system. We documented any signs and symptoms of potential adverse events. RESULTS In total, 47 out of 168 patients (28%) experienced adverse effects, which were mostly mild or moderate. In 13 patie…
Cardiac MR enables diagnosis in 90% of patients with acute chest pain, elevated biomarkers and unobstructed coronary arteries
2015
To assess the diagnostic value of cardiac MRI (CMR) in patients with acute chest pain, elevated cardiac enzymes and a negative coronary angiogram.This study included a total of 125 patients treated in the chest pain unit during a 39-month period. Each included patient underwent MRI within a median of 3 days after cardiac catheterization. The MRI protocol comprised cine, oedema-sensitive and late gadolinium-enhancement imaging. The standard of reference was a consensus diagnosis based on clinical follow-up and the synopsis of all clinical, laboratory and imaging data.MRI revealed a multitude of diagnoses, including ischaemic cardiomyopathy (CM), dilated CM, myocarditis, Takotsubo CM, hyperte…
Prognostic value of soluble urokinase plasminogen activator receptor in patients presenting to the emergency department with chest pain suggestive of…
2021
International audience; INTRODUCTION: Soluble urokinase plasminogen activator receptor (suPAR) is a prognostic biomarker of cardiovascular disease. OBJECTIVES: We aimed to evaluate the early prognostic value of suPAR in patients presenting to the emergency department (ED) with chest pain suggestive of acute coronary syndrome (ACS). PATIENTS AND METHODS: In a post-hoc analysis from a multicenter study including patients with a chest pain < 6 h, suPAR concentrations at ED admission were studied according to the outcome at 30-days. RESULTS: 198 patients (median age 56 years) in whom 16% had an ACS, were included. Fifteen (7.3%) patients presented a 30-day event. At ED admission, median (IQR…
Decision making in a presumptive case of STEMI-like myocarditis
2015
In youngmales, differential diagnosis during chest pain is not always easy. When ECG findings suggest a cardiac origin of such symptoms, myo-pericarditis is usually themost likely hypothesis, beingmore common than Acute Coronary Syndromes (ACS) in the first decades of life [1]. In the presence of ST segment elevation, Troponin release and ventricular wall motion abnormalities, the diagnosis can be challenging, though. In the young a lowcoronary risk profile and atypical symptoms seldom support a working diagnosis of Coronary Heart Disease (CHD), and, therefore, urgent coronary angiography is not recommended routinely, although cases of early ACS are not so rare. In October 2014 a 26-year-ol…