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Query: UMLS:C0008031 (chest pain)
 17,248 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

There were two cases of fatal interstitial pneumonia secondary to bleomycin sulfate administration. Although bleomycin pulmonary toxicity is generally thought to be dose-related and occurs infrequently with a total cummulative dose less than 300 to 400 units, the two reactions reported here occurred with doses of 105 and 165 units. Fatal bleomycin-induced pneumonia has been previously reported at these low dosages, and physicians should be aware that this toxic reaction may occur as an idiosyncratic response. Previous thoracic irradiation may be a predisposing factor. Patients receiving bleomycin should be meticulously monitored by interrogation for cough, dyspnea, and chest pain; by auscultation for rales; by serial chest roentgenograms; and by determinations of vital capacity and single-breath carbon monoxide diffusing capacity.
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PMID:Fatal pulmonary reaction from low doses of bleomycin. An idiosyncratic tissue response. 5 5

Response of intrathoracic symptoms to thoracic irradiation was evaluated in 330 patients. Superior vena caval syndrome and hemoptysis showed the best response, with rates of 86% and 83%, respectively, compared to 73% for pain in the shoulder and arm and 60% for dyspnea and chest pain. Atelectasis showed re-expansion in only 23% of cases, but this figure increased to 57% for patients with oat-cell carcinoma. Vocal cord paralysis improved in only 6% of cases. Radiation therapy has a definite positive role in providing symptomatic relief for patients with carcinoma of the lung.
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PMID:Radiation therapy in bronchogenic carcinoma. 10 98

A case is presented of a 60-year-old woman with fatigue, dyspnea, and chest pain. A chest x-ray film revealed an abnormal cardiac silhouette. Echocardiography revealed a large, echo-free area with well-demarcated, discrete borders adjacent to the right heart border. This structure decreased in size with inspiration and did not show pulsatile cardiac motion. Cardiac catheterization confirmed the extracardiac nature of the lesion and also showed a "constrictive" pattern with equalization of diastolic pressures. Surgical exploration revealed a large cystic thymoma. With removal of the tumor, intracardiac pressures returned to normal.
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PMID:Cystic thymoma simulating contrictive pericarditis. The role of echocardiography in the differential diagnosis. 12 66

A case of primary haemangio-endotheliosarcoma of the right atrium is reported. A review of the literature is given and in all but four of the 56 cases, the tumour originates in the right atrium projecting into the cavity. This explains why these tumours present a rather uniform clinical picture characterized by superior vena caval syndrome combined with pericardial effusion, cardiomegaly, dyspnoea and chest pain. A male dominent sex distribution of 3 to 1 is found. The tumour is highly malignant and has caused death within an average of six months. We emphasize the possibility of early diagnosis particularly since eht clinical symptoms are rather typical and cases are reported where therapy apparently was successful.
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PMID:Cardiac haemangio-endotheliosarcoma. Review of the literature and report of a case. 13 30

An outbreak of cadmium intoxication in a jewelry factory provided an opportunity for evaluating the usefulness of diagnostic procedures used to evaluate human cadmium toxicity. Blood cadmium levels in workers exposed to cadmium were higher (.93 micrograms/100ml vs .38 micrograms/100 ml) than in unexposed workers. A dose-response relationship was noted between blood cadmium level and symptom prevalence in four symptoms (dyspnea, chest pain, dysuria, and dizziness). Segmental hair analysis revealed highest cadmium levels (up to 19 micrograms/gm) in segments formed prior to cadmium exposure, suggesting that extrinsic contamination was the primary source of cadmium in the hair. beta2-microglobulin levels were within normal limits. No significant renal or pulmonary dysfunction was noted. Symptoms ceased after a cadmium-containing brazing alloy used in jewelry production was replaced, yet urine cadmium levels remained persistently elevated in four workers. Blood cadmium determinations were found to be useful in evaluating symptoms potentially related to cadmium intoxication.
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PMID:Subacute cadmium intoxication in jewelry workers: an evaluation of diagnostic procedures. 22 21

The purpose of this study was to determine whether adult patients with chronic obstructive pulmonary disease (COPD) can safely perform pulmonary hygiene measures without compromising their arterial oxygen saturation (SaO2) levels (less than 80 per cent). In 15 male veterans with moderate-to-severe COPD an ear oximeter was used to measure SaO2 levels while subjects completed a series of percussion, deep breathing, and coughing maneuvers in the head-down position (50 degree angle). No clinically significant changes in SaO2 levels were found in 14 subjects during pulmonary hygiene measures, but potentially dangerous symptoms were noted in two subjects. Our study supports the monitoring of objective and subjective symptoms during pulmonary hygiene and discontinuance of the procedure if tachycardia, palpitations, dyspnea, chest pain, or other distressful symptoms occur that might indicate hypoxemia.
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PMID:Effect of pulmonary hygiene measures on levels of arterial oxygen saturation in adults with chronic lung disease. 24 25

The relationships between aortic stenosis, coronary artery disease, angina pectoris, and myocardial infarction were examined in 173 patients with isolated calcific aortic stenosis who had coronary arteriography as well as cardiac catheterization. All were over age 40 and had definite cardiac symptoms; 156 later had aortic valve replacement. Coronary lesions narrowing the lumen by 50% or more were present in 37% of patients aged 40 to 59 and 68% of those aged 60 to 82. Coronary disease was present in 64% of patients with angina pectoris and 33% of those without angina. Angina which occurred only in association with dyspnea on exertion was associated with coronary disease in 45% of instances, whereas angina which also occurred on exertion without any dyspnea or which occurred with emotional stress, after meals, during sleep, or at rest unprovoked was associated with coronary disease in 80% of instances. Patients with coronary disease without any chest pain or with atypical pain considered nonanginal were men, usually over age 60, with congestive heart failure as the predominant symptom. Electrocardiograms showing transmural inferior or anterolateral infarction nearly always indicated coronary disease, while QS patterns in Leads V1-2 occurred frequently with normal coronary arteries. Serum cholesterol was elevated in 23% of those with coronary disease and 8% of those without. A group of patients with moderate aortic stenosis could be identified, with aortic valve areas of 0.55 to 0.80 cm. per square meter, in whom coronary disease was the sole or chief cause of symptoms. The operative mortality rate with aortic valve replacement was 9.6% in those with coronary disease and 1.4% in those without significant coronary disease. Coronary disease is frequently present in patients with calcific aortic stenosis, particularly in those over 60, those with angina, and those with symptoms despite only moderate aortic stenosis. The type of anginal syndrome, the ECG evidence of transmural infarction, and the coronary risk factors provide additional clues for clinical diagnosis.
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PMID:Aortic stenosis, angina pectoris, and coronary artery disease. 30 Feb 16

The clinical, laboratory, and pathological features of six primary lymphoproliferative conditions of the lung are described. These comprise two patients with malignant lymphomas, one with pseudolymphoma, one with lymphoid interstitial pneumonia (LIP), one with lymphomatoid granulomatosis, and one with plasma cell granuloma. We recommend that the term 'premalignant lymphoma' be used for pseudolymphoma since the condition, although tending to remain localised, has a malignant potential. A combination of dyspnoea, cough, and pyrexia were the presenting features in our cases of premalignant and malignant lymphoma although they may often be discovered accidentally by chest radiography. The patient with LIP presented with the usual symptoms of dyspnoea and cough. The initial manifestations of the patient with lymphomatoid granulomatosis were skin radh and peripheral neuropathy nine months before the pulmonary symptoms, a not unusual occurrence. Plasma cell granuloma is often asymptomatic but our patient presented with cough, chest pain, haemoptysis. Premalignant lymphoma tends to pursue a benign course although exceptionally it may become disseminated. Malignant lymphoma may remain localised for many years but a significant proportion metastasise. Lymphomatoid granulomatosis and LIP have a varied course but both may terminate in malignant lymphoma. Plasma cell granuloma is always benign. The interrelationships of these conditions and their differential diagnosis are discussed.
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PMID:Primary lymphoproliferative conditions of lung. 30 83

Coronary angiography was performed before and after coronary revascularization in 67 patients. The interval between studies ranged from 1 to 38 months (average 9.9). The patients were separated into four clinical groups on the basis of their symptoms at the time of restudy; Group I, 13 asymptomatic patients; Group II, 19 patients with nonanginal chest pain (18 cases) or dyspnea (1 case); Group III, 12 patients whose angina was relieved but not eliminated; and Group IV, 23 patients whose angina was not alleviated. The graft patency rate was 72 percent in Group I, 78 percent in Group II, 61 percent in Group IIII and 34 percent in Group IV. The sum of diseased, but not bypassed and unsuccessfully bypassed arteries per patient was 1.6 in Groups I and II. 2.9 in Group III and 4.0 in Group IV. The incidence of perioperative myocardial infarction, defined using enzymatic and electrocardiographic criteria, was 8 percent for Group I, 26 percent for Group II, 25 percent for Group III and 52 percent for Group IV. Anginal relief after coronary bypass surgery is achieved by successful and complete revascularization rather than by perioperative myocardial infarction.
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PMID:Mechanism of relief of angina after coronary bypass surgery: an angiographic study. 31 47

The clinical and radiological characteristics of 217 consecutive episodes of gram-negative bacillary pneumonia occurring in 189 adult cancer patients between November 1968 and December 1974 were analyzed. The majority of patients had acute leukemia (54%). Fever larger than or equal to 101 degrees F was the single most common symptom and sign of the presence of infection (90%). Next in frequency were crepitant rales (65%), cough (41%), dyspnea (19%) and chest pain (18%). Radiographic evidence of pneumonia was found in 83% of cases and it consisted mainly of alveolar infiltrates involving both lung fields and predominantly the bases. Up to one-third of the patients had normal chestx-ray examinations at the onset of infection, though they subsequently became abnormal in 42% of them. The majority of patients (81%) whose initial chest x-rays did not reveal the presence of pneumonia were neutropenic (less than 1000 circumlating neutrophils/mm3). Klebsiella sp. and Pseudomonas sp. were the most common infecting organisms. The overall cure rate was 61%; 70% for Klebsiella sp. infections and 64% for Pseudomonas sp. infections. Pulmonary abscesses occurred in 14% of the cases. Cures were related to the antibiotic sensitivity of the infecting organisms and to the number of circulating neutrophils during the period of infection. Best results were obtained with the administration of gentamicin, the newer aminoglycoside antibiotic sisomicin, tobramycin and amikacin, or the combination of gentamicin with carbenicillin or with cephalosporins. Early and vigorous therapy of gram-negative bacillary pneumonia with appropriate antibiotics has improved the prognosis of this infection at our institution.
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PMID:Gram-negative bacillary pneumonia in the compromised host. 32 40


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