Ankle-Brachial Index in Addition to Stress Testing in Patients Who Presented With Chest Pain and 1-Year Major Cardiovascular Events

Conclusions: Although additional research needs to be conducted, either an abnormal stress test or abnormal ABI suggested an increase of MCE at 1 year with abnormal stress test and ABI demonstrating the highest risk. The addition of ABI to patients undergoing stress testing may enhance risk stratification in patients who present with chest pain.
Source: Critical Pathways in Cardiology - Category: Cardiology Tags: Original Articles Source Type: research

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We report the case of a 58-year-old woman presenting with recurrent episodes of constrictive chest pain during exercise within the last 2 weeks. Except for obesity, general and cardiovascular clinical examination on admission were normal. Diagnoses: The resting 12 lead electrocardiogram (ECG) revealed changes typically for Wellens syndrome. High-sensitive cardiac troponin I was normal. We established the diagnosis of low-risk non-ST-segment elevation acute coronary syndrome with a Global Registry of Acute Coronary Events risk score of 92 points. Interventions: The patient underwent coronary angiography, who showed su...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
 This ECG was texted to me with the question" Wellens'? "The computer read was: Atrial Fibrillation, marked ST Elevation. ***Acute MI***The QT interval is short (377 ms, QTc = 399 ms)This is NOT atrial fibrillation: There is sinus arrhythmia with an accelerated junctional rhythm that competes with the sinus node and results in some AV dissociation (no AV block!).  This is completely benign.I responded: This STE with T-wave inversion looks like a normal variant for an African American.  I would check the troponin, but I do not think it is pathologic.Here is the history: The patient wa...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Conclusion: This represents the largest study of patients with VPR and angiographically-proven ACO. The MSC were highly sensitive and specific for the diagnosis of ACO in patients presenting to the ED with VPR and symptoms of acute coronary syndrome.===================================MY Comment by KEN GRAUER, MD (10/4/2020):===================================Today ’s case provides a superb example of how acute OMI can sometimes be definitively recognized even in the presence ofpacing. Unfortunately, this was not recognized by the cardiology team despite...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
I was reading through a stack of ECGs to put in the formal interpretation, and came across this one:This was my interpretation without having any clinical information:" There is suspicion forevolving infarction in inferior, lateral, and posterior walls. " ( " Evolving " means that it has been going on for some time, is not very acute, probably subacute) Then I went into the patient's chart:This was a 50-something female who presented from an outside hospital in the very early hours with " NSTEMI. " The patient started having pain the previous evening.  She reported that she was leavi...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Acute chest pain and nonspecific chest symptoms in Duchenne muscular dystrophy (DMD) patients may be signs of myocardial injury and decline in cardiac function. Detailed clinical observations of these myocardial events and associated symptoms are therefore vital for better patient management. We retrospectively examined changes in the electrocardiogram (ECG) and cardiac function in three DMD patients with prolonged periods of acute chest pain. Chest pain onset was 9 years of age in case 1, 12 years in case 2, and 16 years in case 3.
Source: Neuromuscular Disorders - Category: Neurology Authors: Source Type: research
We report a case of a 49‐year‐old man with a history of smoking who presented to the emergency department with a 1 day history of chest pain that was exacerbated 5 h prior to presentation. Detailed clinical investigations and coronary angiogr aphic characteristics were recorded. The first ECG of the patient was consistent with de Winter syndrome. Acute coronary artery angiography showed that the proximal left anterior descending coronary artery was completely occluded after the first diagonal branch artery was given off. A percutaneous c oronary intervention was immediately performed. Our case indicates that ...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Case Report Source Type: research
CONCLUSION: This case highlights a unique etiology of acute myocardial infarction in a patient with SAH leading to ST elevations, diffuse triple vessel CAV and apical scar. PMID: 33014294 [PubMed]
Source: World Journal of Cardiology - Category: Cardiology Authors: Tags: World J Cardiol Source Type: research
Rationale: The most common cardiac involvement of Fabry disease (FD) is left ventricular hypertrophy (LVH), which usually occurs in male patients over the age of 30. In rare cases, it can progress to ventricular dilation in the late stage of the disease. Patient concerns: A 16-year-old boy presenting with recurrent extremity pain and chest distress was admitted to our hospital. Imaging examinations revealed ventricular dilation. Diagnosis: α-Galactosidase A enzyme assay and GLA gene sequencing confirmed the diagnosis of FD and revealed a novel mutation c.76_77insT. Interventions: The patient was treated us...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
ConclusionReview of a global database of suspected ADR reports revealed sex differences in the reporting patterns for drugs used in the treatment of COVID-19. Patterns of ADR sex differences need further elucidation.
Source: Drug Safety - Category: Drugs & Pharmacology Source Type: research
Case submitted by Dan Singer MD and Ryan Barnicle MD, Written by Pendell MeyersA woman in her 60s with history of smoking presented to the ED with left sided chest pain radiating to the left arm and back, starting at about 1330. She described the pain as a " heaviness, " without exacerbating or alleviating factors. Her pain at the time of arrival was 10/10.Here is her triage ECG (no prior for comparison):What do you think?Findings: - Sinus rhythm at around 100 bpm - Grossly normal QRS complex - 1.0 mm STE in lead III, and just a hint of STE in aVF (both of which have to be measured just after signi...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
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