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Query: UMLS:C0008031 (
chest pain
)
17,248
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Spinal cord infarction is uncommon and usually presents with sudden onset of paralysis and sensory disturbances. A variety of causes are described, but rarely with multiple factors involved. We report a case of a 63-year-old man with a history of diabetes mellitus, hypertension, and osteoarthritis who presented with acute onset of
chest pain
, numbness, and weakness associated with episodic hypotension. He had incomplete tetraplegia and was areflexic without spasticity. Pain and temperature sensations were impaired below the C7 dermatome and absent below the T4 dermatome bilaterally. Proprioception and vibration sensations were diminished on the right below the C6 dermatome. Magnetic resonance imaging showed spinal cord infarction affecting C6-T3 segments, and severe cervical and lumbar spine degenerative changes. This case illustrates an unusual presenting symptom of spinal infarction, the need to identify multiple risk factors for spinal cord infarction, and the importance of optimal preventive therapy in patients at risk.
J
Gen
Intern Med 2007 Jan
PMID:Spinal cord infarction with multiple etiologic factors. 1735 58
Congenital defects of the pericardium are rare. This report describes a young woman with a congenital complete pericardial defect who developed a giant pulmonary cyst. After operation the patient experienced
chest pain
caused by myocardial ischemia due to cardiac displacement. It is important to note that heart lability in patients with congenital pericardial defects may cause grave complications after thoracotomy associated with volume loss of the residual lung.
Gen
Thorac Cardiovasc Surg 2007 Feb
PMID:Giant pulmonary cyst associated with congenital pericardial defect. 1744 79
We report a case of successful urgent surgical therapy for a Stanford type A acute aortic dissection with cerebral malperfusion. A woman with a sudden severe
chest pain
consulted the emergency department. Computed tomography results showed a Stanford type A acute aortic dissection. She had repeating left paralysis, so a cerebrovascular study was performed. It showed that the collateral left carotid and vertebral arteries perfused only the right cerebral hemisphere. Hence, it was thought that the left paralysis was caused by cerebral malperfusion due to the dissection. Simple aortic replacement endangered the right cerebral hemisphere, so we performed urgent revascularization of the right carotid artery, followed by an ascending aortic replacement procedure.
Gen
Thorac Cardiovasc Surg 2007 Jul
PMID:Urgent simultaneous revascularization of the carotid artery and ascending aortic replacement for type A acute aortic dissection with cerebral malperfusion. 1767 56
A 31-year-old woman was admitted to our hospital with sudden onset of
chest pain
. Chest radiography and computed tomography (CT) on admission showed an anterior mediastinal tumor with left pleural effusion, which was diagnosed as an inoperable malignant mediastinal tumor. However, 3 weeks after admission CT showed that the tumor was diminishing and the pleural effusion had disappeared without any treatment. CT-guided needle biopsy was performed, but diagnosis was impossible because most of the specimen was necrotic. A biopsy during video-assisted thoracic surgery was then performed. The intraoperative finding showed that the tumor was round, well mobilized, and did not invade adjacent structures. It was then assumed to be a benign teratoma that had been ruptured into the thoracic cavity. The operation was converted to a thoracotomy to resect it, but it could not be completely resected because of inflammatory adhesions to the mediastinum. Two months later, total thymectomy was performed through a median sternotomy because the tumor was pathologically diagnosed as a thymoma.
Gen
Thorac Cardiovasc Surg 2007 Dec
PMID:Thymoma with spontaneous regression and disappearance of pleural effusion. 1806 46
A 79-year-old woman was urgently referred to a district hospital with dull central
chest pain
after swallowing a fish bone. The bone was removed by esophagoscopy. Eleven days later she presented because of hematemesis. Computed tomography and aortic arch angiography confirmed a diagnosis of esophageal perforation leading to mediastinitis and the presence of an infected pseudoaneurysm. The infected pseudoaneurysm was completely resected, followed by direct aorto-aorta anastomosis and omental coverage in a one-stage operation. She improved and was discharged 2 months later.
Gen
Thorac Cardiovasc Surg 2008 Aug
PMID:Perforation of the esophagus by a fish bone leading to an infected pseudoaneurysm of the thoracic aorta. 1869 12
We describe a 65-year-old woman with a history of hypertension and smoking who presented with an acute episode of
chest pain
precipitated by severe emotional stress. Her initial electrocardiogram done in the emergency room showed non-specific T wave changes in the lateral leads and her cardiac troponin levels were mildly elevated. Because of her clinical presentation, she was admitted with a presumptive diagnosis of acute myocardial infarction and managed with antiplatelet and anticoagulant therapy. Coronary angiogram did not reveal coronary artery disease and left ventriculography showed findings consistent with apical ballooning syndrome or takotsubo cardiomyopathy. Subsequent electrocardiograms displayed dramatic changes including T wave inversions, QT interval prolongation and U waves. The patient remained asymptomatic and recovered uneventfully. Three weeks post-discharge, an echocardiogram documented resolved left ventricular dysfunction. We describe the clinical features and highlight the electrocardiographic findings that may help differentiate takotsubo cardiomyopathy from myocardial infarction.
J
Gen
Intern Med 2008 Nov
PMID:It's a trap! Clinical similarities and subtle ECG differences between takotsubo cardiomyopathy and myocardial infarction. 1876 77
We herein report a 38-year-old man who had spontaneous regression of a thymoma with repeating episodes of
chest pain
that initially occurred 2 years earlier when the tumor was 35 mm in the long axis. Left video-assisted thoracoscopic thymothymectomy was performed. Pathology examination showed a thymoma 15 mm in the long axis, classified B2 in the World Health Organization classification and stage II by Masaoka staging. The feeding arteriole of the tumor, occluded by organized thrombi, was suggested to be the cause of coagulation necrosis. The patient recovered well from surgery without complication and with no episodes of
chest pain
at the 9-month outpatient follow-up.
Gen
Thorac Cardiovasc Surg 2008 Sep
PMID:Spontaneous regression of symptomatic thymoma caused by infarction. 1879 75
A 52-year-old man was admitted to Matsudo City Hospital because of an anterior mediastinal mass. One month prior, when he suddenly suffered
chest pain
, computed tomography (CT) showed a 4 x 3 cm mass in the chest. On admission, the symptom disappeared. However, chest CT revealed rapid enlargement of the mass to 10 x 6 cm. Based on the CT findings, we suspected a tumor. Therefore, we performed a thymothymectomy. The mass, measuring 12 x 8 x 6 cm, contained a solid tumor and a fluid-filled cyst. Pathology showed a thymoma and a multilocular thymic cyst. We speculated that hemorrhage from the thymoma spread into the multilocular thymic cyst and enlarged the mass.
Gen
Thorac Cardiovasc Surg 2008 Sep
PMID:Rapid enlargement of a mediastinal mass: thymoma hemorrhage into a thymic cyst. 1879 76
A 63-year-old man with a history of acute coronary syndrome presented with anterior
chest pain
that had lasted more than 3 months. During treatment for acute myocardial infarction on admission, computed tomography (CT) was performed incidentally, revealing an anterior mediastinal tumor 28 mm in diameter. CT findings after 3 months demonstrated an anterior soft tissue mass involving the left brachiocephalic vein and showing rapid growth. Radical resection of the tumor with thymectomy was performed. Histological examination showed storiform-pleomorphic malignant fibrous histiocytoma (MFH) originating from the thymus, and Hassall's bodies were identified. Immunohistochemical staining showed tumor cells with positive results for vimentin and CD68. The Ki-67 index (MIB-1) was >50%, but other markers such as cytokeratin AE1/AE3, smooth muscle actin, S-100 protein, CD34, and CD45 were negative. Mediastinum MFH has been reported in 34 cases, but this appears to be a rare description of MFH originating from the thymus.
Gen
Thorac Cardiovasc Surg 2008 Dec
PMID:Malignant fibrous histiocytoma originating from the thymus. 1908 56
Detecting a rib metastasis as a first manifestation before identifying hepatocellular carcinoma (HCC) is rare. We report an HCC with massive bleeding from the biopsied rib tumor. A 68-year-old man was referred for right
chest pain
. Computed tomography showed a mass in the rib and two small masses in the liver. The biopsied rib continued to bleed, so we removed the entire tumor, including the rib. We histologically confirmed the diagnosis as rib metastasis from the HCC. The patient died 3 months after the onset. We caution against performing an incisional biopsy without due consideration.
Gen
Thorac Cardiovasc Surg 2009 Jan
PMID:Hepatocellular carcinoma associated with hemorrhaging from iatrogenic rupture of a rib metastasis. 1916 14
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