How did your aortic dissection cases present?

My mind is racing because I’ve seen two aortic dissections in the last week and I feel like I could have easily missed them had I been in a rush and not prodded during the history. Makes me cringe thinking about it. First one was a 69 year old with hypertension. Sudden onset of chest pain when watching TV. With no other symptoms at all. The thing that tipped me off is he didn’t want to move. Moving hurt his chest. Breathing hurt his chest. Me pushing on his chest made him wince. Just didn’t... How did your aortic dissection cases present?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Emergency Medicine Source Type: forums

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Authors: Shao C, Wang J, Tian J, Tang YD Abstract In most developed countries, coronary artery disease (CAD), mostly caused by atherosclerosis of coronary arteries, is one of the primary causes of death. From 1990s to 2000s, mortality caused by acute MI declined up to 50%. The incidence of CAD is related with age, gender, economic, etc. Atherosclerosis contains some highly correlative processes such as lipid disturbances, thrombosis, inflammation, vascular smooth cell activation, remodeling, platelet activation, endothelial dysfunction, oxidative stress, altered matrix metabolism, and genetic factors. Risk factors ...
Source: Advances in Experimental Medicine and Biology - Category: Research Tags: Adv Exp Med Biol Source Type: research
SOUTH SAN FRANCISCO, CA, April 3, 2020 – Actelion Pharmaceuticals US, Inc., a Janssen Pharmaceutical Company of Johnson &Johnson, today announced that CHEST, the official publication of the American College of Chest Physicians, published results from an expert Delphi consensus survey that help provide additional insights for physicians to advance the care of patients with pulmonary arterial hypertension (PAH).The Prostacyclin International Expert Panel developed the consensus opinions based on common clinical scenarios in which they considered adding oral prostacyclin pathway agents (PPAs), including UPTRAVI®...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
DISCUSSION: Our case highlights how DIL should be on the differential when seemingly disparate symptoms develop in a patient receiving DIL-associated medications. Lupus is one of the "great imitators," in which symptoms can be ascribed to many different underlying causes. Although this patient's presentation may have been confounded by concomitant histoplasmosis, his improvement with cessation of hydralazine treatment argues in favor of DIL. His continued atypical serologic test results could be residual from his DIL and should normalize with time. However, it raises the question whether this bout of DIL has unma...
Source: The Permanente journal - Category: General Medicine Tags: Perm J Source Type: research
Conclusion: Uncontrollable reduction of high BP in some patients with hypertension could increase the risk for chronic pain incidence and its severity. Practical recommendations in BP control should be reconsidered to take into account patients’ chronic pain. Further research is needed of moderation effects of different antihypertensive manipulations on pain to improve pain management in these patients.
Source: Journal of Hypertension - Category: Cardiology Tags: ORIGINAL PAPERS: Treatment Source Type: research
Hepatic veno-occlusive disease (VOD) or sinusoidal obstruction syndrome (SOS) is a rare complication characterized by hepatomegaly, right-upper quadrant pain, jaundice, and ascites, occurring after high-dose chemotherapy, hematopoietic stem cell transplantation (HSCT) and, less commonly, other conditions. We review pathogenesis, clinical appearance and diagnostic criteria, risk factors, prophylaxis, and treatment of the VOD occurring post-HSCT. The injury of the sinusoidal endothelial cells with loss of wall integrity and sinusoidal obstruction is the basis of development of postsinusoidal portal hypertension responsible f...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
High blood pressure symptoms can be difficult to spot, but may include chest pain, finding blood in your urine, and having severe headaches. You could also be at risk of deadly hypertension - and even "sudden death" - if you develop any of these early signs.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
A 44-year-old woman with a history of hypertension and partial gastrectomy presented to the emergency department with low thoracic back pain of 2  days' duration without red flag symptoms. The physical examination was significant for point tenderness to palpation in the lower thoracic spine without overlying skin changes or neurologic symptoms. Considering her large body habitus and history of gastrectomy, a thoracic radiograph was obtained to rule out compression fracture due to osteoporosis (Figure 1).
Source: The Journal of Emergency Medicine - Category: Emergency Medicine Authors: Tags: Visual Diagnosis in Emergency Medicine Source Type: research
(CNN) — It’s a scenario all too many of us are facing — or will soon face. You or a loved one has a mild fever, body aches, the start of a nagging, dry cough. Food doesn’t taste good nor smell as it once did. Maybe you have shortness of breath or struggle to breath deeply. You’ve called your doctor, and you are suddenly face-to-face with the scary reality of Covid-19. What happens next depends on your specific circumstances. If you are having trouble breathing or are elderly and fragile, you may be hospitalized and tested for the virus. If you’re not in immediate danger but potentially h...
Source: WBZ-TV - Breaking News, Weather and Sports for Boston, Worcester and New Hampshire - Category: Consumer Health News Authors: Tags: Boston News Featured Health CNN Coronavirus quarantine Source Type: news
RARITAN, NJ, March 28, 2020 – The Janssen Pharmaceutical Companies of Johnson &Johnson today announced the VOYAGER PAD study met its primary efficacy and principal safety endpoints, demonstrating the XARELTO® (rivaroxaban) vascular dose (2.5 mg twice daily) plus aspirin (100 mg once daily) was superior to aspirin alone in reducing the risk of major adverse limb and cardiovascular (CV) events by 15 percent in patients with symptomatic peripheral artery disease (PAD) after lower-extremity revascularization, with similar rates of TIMI[1] major bleeding. VOYAGER PAD is the only study to show a significant benefit...
Source: Johnson and Johnson - Category: Pharmaceuticals Tags: Innovation Source Type: news
Pain, the hallmark symptom of chronic pancreatitis, remains difficult to treat, particularly given the unclear mechanism of pain in this disease.1 Pain likely results from an interplay between pancreatic ductal and parenchymal hypertension in combination with neural remodeling and sensitization, making it particularly challenging to identify which patients will respond to which treatments.2
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Original article Source Type: research
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