History of gastroesophageal reflux disease in patients with suspected coronary artery disease

AbstractIt is well known that patients with gastroesophageal reflux disease (GERD) experience GERD-related chest pain, but little is known about the relationship between GERD and coronary artery disease (CAD). We evaluated medical history of GERD in patients with suspected CAD and its association with types of CAD. We enrolled 236 patients who underwent coronary angiography (CAG). We assessed past medical history of each patient, making note of esophageal or stomach diseases such as GERD including reflux esophagitis and non-erosive reflux disease. The patients were divided into the following three subgroups based on the CAG results. Group I, patients with o-CAD (>  50% stenosis with ischemic findings,n = 141); Group II, patients with vasospastic angina (VSA, with positive spasm provocation test without organic coronary stenosis,n = 52); and Group III, patients without organic coronary stenosis or VSA (n = 43). Group I included more men than women (p 
Source: Heart and Vessels - Category: Cardiology Source Type: research

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A 45-year-old man presented to the emergency department at an outside facility with severe right upper quadrant abdominal pain, radiating to his back with deep inspiration. The pain had started the evening before, and the patient described it as dull and aching with intermittent episodes of sharp, stabbing discomfort. The pain was not associated with fever, nausea, vomiting, or diarrhea. He had no recent travel history. His medical history was notable for hypertension, type 2 diabetes mellitus, and gastroesophageal reflux disease.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Residents' clinic Source Type: research
Question: A 56-year-old man with a history of mild dysphagia for 4 months experienced worsening of his symptoms when he caught a cold or was tired, but without nausea, vomiting, acid reflux, abdominal pain, or bloating. He had no history of diabetes mellitus, hypertension, or heart disease, and did not smoke or drink alcohol. Physical examination was unremarkable.
Source: Gastroenterology - Category: Gastroenterology Authors: Tags: Electronic Clinical Challenges and Images in GI Source Type: research
A 62-year-old tall, thin African American man presented to the emergency department after four days of constipation and vomiting. He had decreased mental status, and was unable to provide a complete medical background. His spouse reported that the patient had diffuse abdominal pain for the past four days, and had been experiencing increased thirst and excessive urination for the past four weeks.She reported that the patient was unresponsive to over-the-counter laxatives and had been unable to produce bowel movements. The patient had no prior abdominal surgery, medication use, or primary care visits. The patient used to be ...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Abstract Gastrointestinal disorders are common complications of diabetes mellitus and include gastroparesis, nonalcoholic fatty liver disease, gastroesophageal reflux disease, and chronic diarrhea. Symptoms of gastroparesis include early satiety, postprandial fullness, nausea, vomiting of undigested food, bloating, and abdominal pain. Gastroparesis is diagnosed based on clinical symptoms and a delay in gastric emptying in the absence of mechanical obstruction. Gastric emptying scintigraphy is the preferred diagnostic test. Treatment involves glucose control, dietary changes, and prokinetic medications when needed....
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research
A 72-year-old white man with diabetes mellitus and  gastroesophageal reflux, with no history of liver disease, hepatobiliary instrumentation, sphincterotomy, or abdominal trauma, presented with acute right upper quadrant abdominal pain and diaphoresis that had started 1 hour earlier. Physical examination revealed a soft and nontender abdomen. The initial serum liver function test results were all within normal limits but rose acutely to a serum alkaline phosphatase of 224 U/L, aspartate aminotransferase of 355 U/L, alanine aminotransferase of 531 U/L, and total bilirubin of 2.4 mg/dL after 48 hours.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: At the focal point Source Type: research
Question: A 22-year-old man with history of type 1 diabetes mellitus, alpha-1-antitrypsin deficiency (ZZ phenotype), gastroesophageal reflux disease, hyperlipidemia, and depression presented to the hospital for increasing right upper quadrant pain and nausea for 2 weeks. The patient was a former heroin user and an active smoker, but denied significant alcohol use. The patient’s home medications included insulin, atorvastatin, dexlansoprazole, paroxetine, buprenorphine, and trazodone. The patient had poorly controlled diabetes, requiring 6 hospitalizations for diabetic ketoacidosis within the last year.
Source: Gastroenterology - Category: Gastroenterology Authors: Tags: Electronic Clinical Challenges and Images in GI Source Type: research
Background: When patients present to the emergency department with a complaint concerning for heart disease, this often becomes the primary focus of their evaluation. While patients with noncardiac causes of chest pain outnumber those with cardiac causes, noncardiac etiologies are frequently overlooked. We investigated symptoms and noncardiac conditions in a cohort of patients with chest pain at low risk of cardiac disease. Methods: We analyzed data from a prospective registry of patients who were evaluated in our chest pain evaluation center. Registry participants completed standardized and validated instruments for depre...
Source: Critical Pathways in Cardiology - Category: Cardiology Tags: Original Articles Source Type: research
Purpose of review: Gastroparesis is a disorder with delayed gastric emptying in the absence of mechanical obstruction. It is one of the more common dysmotilities that occur in the gastrointestinal tract, and is thought to primarily affect adults. Pediatric cases of gastroparesis were considered rare; however, recent evidence suggests growing recognition in children and adolescents. Therefore, it is important for the pediatric caregiver to understand the condition and the treatment options available. Recent findings: The majority of patients are women, and presentation is usually with symptoms of persistent nausea, emesis, ...
Source: Current Opinion in Pediatrics - Category: Pediatrics Tags: SURGERY: Edited by Brad W. Warner Source Type: research
A 45-year-old woman with a history of medication-controlled essential hypertension, stage 2 chronic kidney disease, type 2 diabetes mellitus, and a pack-a-day cigarette habit presented less than 60 minutes after acute onset of severe shortness of breath that awoke her from sleep. She had felt well the previous day, and went to bed with no complaints.   Around 4 a.m., she woke up from sleep very dyspneic, with moderate chest “discomfort” over her left chest that radiated to her back and was unchanged by position or respirations. She denied other symptoms such as fever, cough, nausea, vomiting, numbness, o...
Source: Spontaneous Circulation - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs
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