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Query: UMLS:C0000737 (
abdominal pain
)
31,184
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
We describe a patient who presented with
abdominal pain
radiating to the chest and ST elevation in the precordial leads, mimicking
acute myocardial infarction
. Urgent coronary angiography revealed normal coronary arteries and his serum troponin has not increased. Subsequently, he was found to have severe hypercalcemia. ST segment elevation resolved after correction of hypercalcemia. This phenomenon of ST elevation secondary to hypercalcemia has been described only two times in the English literature to date.
...
PMID:Hypercalcemia-induced ST-segment elevation mimicking acute myocardial infarction. 1702 38
The case is presented of a 66 year old woman who attended the emergency department with severe
abdominal pain
subsequent to a bout of coughing, following a week's history of productive cough. She was known to have chronic obstructive pulmonary disease and was also on warfarin for recurrent deep vein thromboses. She had no history of ischaemic heart disease. She was found to have a rectus sheath haematoma and an international normalised ratio of 7.7, and admission was arranged for coagulation control and analgesia. However, a routine electrocardiograph (ECG) demonstrated an ST elevation pattern consistent with an acute inferior infarction. Subsequent ECGs showed no ST elevation, although the axis and chest lead QRS morphology remained the same throughout the first 12 hours. Over the next three days, R wave progression decreased in the chest leads. Troponin I at admission and 24 hours later were both <0.2 ng/ml. ECG changes compatible with
acute myocardial infarction
have been reported in association with a number of non-cardiac presentations; however, to our knowledge, it has never been reported in relation to a rectus sheath haematoma. We speculated on the possible mechanism of such "pseudo myocardial infarction" and the importance of treating the patient, not the ECG.
...
PMID:Pseudo myocardial infarction. 1685 85
Although cardiovascular mortality for men has been declining, the number of women dying from cardiovascular disease has slightly increased. Differences between women and men have been identified throughout the entire spectrum of ischemic heart disease, from risk factors to presentation and from diagnosis to treatment and outcomes. In the setting of an acute coronary syndrome or
acute myocardial infarction
, women are significantly more likely than men to report multiple non-chest pain symptoms, including dyspnea, nausea/vomiting,
abdominal pain
, back pain, neck pain, and jaw pain. Investigations into the pathophysiology of ischemic heart disease in women have broken away from the traditional thinking that coronary artery disease simply equals epicardial stenosis. In women, the new paradigm of coronary artery disease also focuses on diffuse atherosclerosis, endothelial dysfunction, and microvascular disease. Further research focusing on sex differences in cardiovascular disease is needed, but enough is currently known to offer a sex-based approach, which may ultimately lead to improved outcomes.
...
PMID:Ischemic heart disease in women: an appropriate time to discriminate. 1760 24
Acute mesentery artery embolization is a rare complication of invasive catheterizations. The incidence is unknown. In case of late diagnosis the mortality may reach up to 93%. Acute abdominal pain, vomitus, rapid and sudden bowel evacuation with or without blood are the typical symptoms of the disease. Plain X-Rays of abdomen or CT tomography may show no signs of intestinal ischaemia. The diagnostic method to choose is either spiral CT angiography or contrast angiography, respectively. The most common therapeutical approach is surgical revascularization but in selected cases it is feasible to perform local thrombolysis with a microcatheter placed directly into the artery with embolus. We report a case of a man who was admitted with an
acute myocardial infarction
who underwent primary angioplasty with implantation ofa bare-metal stent. After the procedure he developed severe and progressive
abdominal pain
as a result of acute superior mesentery artery embolization. In this patient we performed a local thrombolysis with rt-PA (alteplase) with a great technical success and immediate pain relief, with no need of surgical revision. Our approach was concordant to recommendations cited in this article.
...
PMID:[Superior mesentery artery embolization as a complication of the primary angioplasty solved by local thrombolysis]. 1892 49
Acute myocardial infarction
(MI) complicated with acute pancreatitis has been rarely reported. A 68-year-old man presented to our department 15 hours after development of epigastric pain. In addition to his symptoms, the elevated serum pancreatic enzymes and the image study on abdominal computerized tomography all led to the diagnosis of acute pancreatitis. Elevated cardiac biomarkers and a standard 12-lead electrocardiogram (ECG) demonstrating ST-segment elevation in 5 of the 6 precordial leads suggested an attack of MI. Oral intake was resumed after medical management for his acute pancreatitis and acute MI. Coronary angiogram on day 11 revealed total occlusion of the middle segment of the left anterior-descending coronary artery. Subsequently, angioplasty with stenting was done. The patient was discharged without significant complications. It is critical to make a rapid but detailed differential diagnosis of
abdominal pain
. Even though acute pancreatitis-associated ECG abnormalities have been reported previously, any ECG abnormalities in a patient presenting
abdominal pain
should be evaluated and treated cautiously. Thorough clinical evidence, including history, physical findings, ECG, image studies and serum biomarkers, are informative in seeking and analyzing possible etiologies.
...
PMID:Perplexing epigastric pain-coincident myocardial infarction and acute pancreatitis. 2007 80
Acute pancreatitis is a disease initially located into the pancreas that may become a systemic disease involving organs distant from the pancreas. All organs may be involved during an acute attack of pancreatitis: lungs, kidney, heart, liver, brain. The differential is sometime difficult because acute pancreatitis may sometimes mimic an acute coronary syndrome. We report a case of a 36-year-old man who was admitted to Emergency Room for persistent epigastric pain. Serial electrocardiograms (ECG) showed signs of
acute myocardial infarction
. However, a coronary angiogram demonstrated no coronary artery disease, and serum troponin was undetectable. Later, serum pancreatic enzyme levels were elevated and an ultrasonography scan of the abdomen was consistent with pancreatitis. Physicians should keep in mind the possibility of an attack of pancreatitis in a patient with
abdominal pain
and ECG modifications who is a heavy drinker.
...
PMID:Abdominal pain and ECG alteration: a simple diagnosis? 2049 72
We report a case of three severe embolic complications due to warfarin withdrawal. An 83-year-old man with hypertension, angina pectoris and atrial fibrillation underwent bladder biopsy under spinal anesthesia after 13 days of warfarin withdrawal. On the second postoperative day, the patient complained of chest pain and was diagnosed as
acute myocardial infarction
. Embolus was successfully removed by suctioning. Warfarin and heparin therapy was started after that. On the 6th postoperative day, the patient complained of
abdominal pain
and was diagnosed as superior mesenteric artery embolism. After suctioning of the thrombus and monteplase injection, symptoms disappeared. On the 9th postoperative day, paralysis on the right side of his body and aphasia appeared. Stroke was suspected. Coma advanced day by day and he died due to brain herniation on the 16th postoperative day. In this patient we should have assessed the risk of the thromboembolic complication and planned the appropriate anticoagulation with closer cooperation with his attending physicians.
...
PMID:[A case of severe embolic complications due to warfarin withdrawal]. 2336 70
A 57-year-old man had been followed up for severe left ventricular dysfunction after
acute myocardial infarction
with a left ventricular thrombus. He had been treated with anticoagulant and antiplatelet therapy and was admitted to our hospital because of
abdominal pain
and shock. He had no prior episode of trauma. The electrocardiogram (ECG) showed no changes compared with the previous ECG. Enhanced abdominal computed tomography (CT) showed a retroperitoneal hematoma around an abdominal aortic aneurysm (AAA) and the right kidney. We suspected rupture of AAA or the right kidney, and we performed AAA replacement with a Y-shaped graft and nephrectomy of the right kidney. Pathological examination revealed hemorrhagic infarction of the lower part of the right kidney, with hemorrhage and rupture at the center of the infarct. In our case, enhanced CT showed extravasation from the lower part of the right kidney. In addition, postoperative echocardiography showed that the left ventricular thrombus had disappeared. We report a case of rupture and bleeding secondary to renal infarction in a patient with an AAA.
...
PMID:Rupture and bleeding secondary to renal infarction in a patient with an abdominal aortic aneurysm. 2353 80
Biventricular takotsubo cardiomyopathy is associated with more hemodynamic instability than is isolated left ventricular takotsubo cardiomyopathy; medical management is more invasive and the course of hospitalization is longer. In March 2011, a 62-year-old woman presented at our emergency department with
abdominal pain
, nausea, and vomiting. On hospital day 2, she experienced chest pain. An electrocardiogram and cardiac enzyme levels suggested an
acute myocardial infarction
. She underwent cardiac angiography and was found to have severe left ventricular systolic dysfunction involving the mid and apical segments, which resulted in a left ventricular ejection fraction of 0.10 to 0.15 in the absence of obstructive coronary artery disease. Her hospital course was complicated by cardiogenic shock that required hemodynamic support with an intra-aortic balloon pump and dobutamine. A transthoracic echocardiogram revealed akinesis of the mid-to-distal segments of the left ventricle and mid-to-apical dyskinesis of the right ventricular free wall characteristic of biventricular takotsubo cardiomyopathy. After several days of medical management, the patient was discharged from the hospital in stable condition. To the best of our knowledge, this is the first review of the literature on biventricular takotsubo cardiomyopathy that compares its hemodynamic instability and medical management requirements with those of isolated left ventricular takotsubo cardiomyopathy. Herein, we discuss the case of our patient, review the pertinent medical literature, and convey the prevalence and importance of right ventricular involvement in patients with takotsubo cardiomyopathy.
...
PMID:Biventricular takotsubo cardiomyopathy: case study and review of literature. 2391 28
We report a case of acute poisoning in a 48-year-old man who presented with chest pain,
abdominal pain
, dizziness, sweatiness, blurred vision, and severe hypotension after ingestion of honey. His electrocardiogram showed sinus bradycardia and transient ST elevation. He made a good recovery after treatment with atropine and close monitoring. Grayanotoxin was detected in his urine and the honey he ingested, which confirmed a diagnosis of mad honey poisoning. This is a condition prevalent in the Black Sea region around Turkey but rarely seen locally. Although mad honey poisoning is life-threatening, early use of atropine is life-saving. Such poisoning may present with ST elevation in the electrocardiogram and symptoms mimicking
acute myocardial infarction
. It is therefore essential for clinicians to recognise this unusual form of poisoning and avoid the disastrous use of thrombolytic therapy.
...
PMID:Mad honey poisoning mimicking acute myocardial infarction. 2391 13
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