Are Patients Discharged on the HEART Pathway Following Up?

CONCLUSIONS: Of the subjects discharged on the HEART Pathway, 67.6% followed up. Of those subjects that followed up, 18% did so at the HEART Clinic. PMID: 32871008 [PubMed - as supplied by publisher]
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research

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A 48-year-old-female was diagnosed with SARS-CoV-2 infection by reverse-transcriptase-polymerase-chain-reaction. One day later, she experienced an episode of acute typical chest pain and was transferred to our hospital due to elevated cardiac enzymes (high-sensitivity Troponin-T: 542,6 ng/l (reference upper level (RUL): 14 ng/l) and creatine kinase (CK): 226 U/l (RUL: 170 U/l). Electrocardiogram showed intermittent negative T-waves in inferior leads (II, III, aVF, V4 and V5) matching with inferior wall motion abnormalities in transthoracic echocardiography, leading to the diagnosis of non ST-elevation myocardial infarction (NSTEMI).
Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Tags: Case report Source Type: research
ConclusionsClinicians may consider deferring immediate cardiac catheterization and attribute electrocardiogram changes to acute pancreatitis in patients presenting with angina pectoris and acute pancreatitis if confirmed by normal cardiac enzymes and elevated levels of lipase and amylase. However, when clinical signs and electrocardiogram findings are highly suggestive of myocardial ischemia/injury, immediate noninvasive coronary computed tomography angiography may be the best approach to make an early diagnosis.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Rationale: Coronary angiography (CAG) findings of acute myocardial infarction (AMI) in pregnant women are characterized by a high incidence of normal coronary arteries. This is the first report of AMI with normal coronary arteries during pregnancy, showing coronary spasm and pregnancy-related acquired protein S (PS) deficiency. Patient concerns: A 30-year-old Japanese woman was admitted to an emergency department. One hour before admission, she developed sudden onset of precordial discomfort, back pain, and dyspnea. She was a primigravida at 39 weeks’ gestation and had no abnormality in the pregnancy thus far. S...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
The aim of this study was to evaluate comparative clinical outcomes of discordant electrocardiographic (ECG) and echocardiographic (Echo) findings compared with concordant findings during treadmill exercise echocardiography in patients with chest pain and no history of coronary artery disease (CAD). A total of 1725 consecutive patients who underwent treadmill echocardiography with chest pain and no history of CAD were screened. The patients were classified into 4 groups: ECG–/Echo– (negative ECG and Echo), ECG+/Echo– (positive ECG and negative Echo), ECG–/Echo+, and ECG+/Echo+. Concomitant CAD was ...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
A patient with DM presented with acute chest pain.Here was his ED ECG:There isLVH in limb leads, with a 17 mm R-wave in aVL, and deep S-wave in inferior leads.With this much voltage, one expects some repolarization abnormalities.Indeed, there is a bit of ST depression in aVL (discordant to the tall R-wave) that does not appear to be out of proportion.There is inferior ST Elevation, but the S-waves are also of high voltage.Is this an inferior STEMI?  Or is the LVH with expected repolarization abnormalities? There is also some ST depression in V2.  Possible posterior involvement?CommentTo me, the inferior ST E...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
I was shown this ECG with no other information:What do you think?Hint: try to see through the artifact!I answered immediately: " High lateral MI with posterior MI. OMI. " (Occlusion Myocardial Infarction)I asked, " Did the patient present with chest pain? "Here is the history:" A middle-aged male complained of about 18 hours of epigastric pain that radiated to the chest.  He also had an apparently new facial droop of equal duration.  A stroke code was called, NIH stroke scale was only 1, and attention was turned to the chest pain. "  BP was 148/83.How did I make this ECG diagnos...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Publication date: Available online 8 March 2019Source: Journal of Cardiology CasesAuthor(s): Hiroaki Hiraiwa, Ryota Morimoto, Takahiro Okumura, Yoshihito Arao, Hideo Oishi, Hiroo Kato, Shogo Yamaguchi, Tasuku Kuwayama, Tomoaki Haga, Tsuyoshi Yokoi, Toru Kondo, Naoki Watanabe, Takayuki Mitsuda, Kenji Fukaya, Akinori Sawamura, Akihito Tanaka, Hideki Ishii, Itsuro Morishima, Hideyuki Tsuboi, Toyoaki MuroharaAbstractA 23-year-old Japanese man presented to a nearby hospital with a complaint of chest pain. In terms of the risk factors for cardiovascular events, there were no abnormal findings in past medical examinations and no ...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
A middle-aged woman with history of hypertension presented to another hospital approximately 2 hours after onset of chest pain and shortness of breath.This ECG was recorded on arrival:What do you think?This is technically a STEMI, with 1.5 mm STE in V1 and 1.5-2.0 mm in V2. The current criteria only require 1mm in V1 and 1.5mm in V2 for a female. However, I think many practitioners might not see this as a clear STEMI, and would instead call this " borderline. " The normal QRS complex with STE and large volume underneath the T-waves in V1-V3 confirm Occlusion MI (OMI). There is not technically STD in V6 and I, how...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
A 59-year-old man was admitted with a 2-h history of stabbing chest pain and dizziness. On arrival he was in shock with an arterial blood pressure of 70/30  mmHg and he had electrocardiographic changes suggestive of lateral ST elevation myocardial infarction (STEMI). Emergency invasive coronary angiography showed stenoses of left anterior descending (75–94%), circumflex (50–74%) and right (50–74%) coronary arteries along with a complete occlusi on of a small obtuse marginal branch. None of these were treated with primary intervention.
Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Tags: Case report Source Type: research
AbstractEvaluation of atypical presentation of angina chest pain in emergency department is difficult. Hospitalization of this patient may impose additional costs and waste the time, early discharge may lead to miss the patients. The aim of this study was to determine volubility of Single Photon Emission Computed Tomography (SPECT) in management of patients admitted to emergency department with atypical manifestations of angina pain, un-diagnostic Electrocardiogram (ECG) and negative enzyme. Half of 100 patients admitted to emergency department with atypical chest pain and un-diagnostic ECG who were candidate for admission...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
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