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Query: UMLS:C0008031 (
chest pain
)
17,248
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
A 66-year-old man with anomalous origin of the right coronary artery suffered from
chest pain
. The results of coronary angiography and multidetector computer tomography indicated that the proximal right coronary artery was intermittently compressed, causing the ischemia. Coronary artery bypass grafting was regarded as a reliable treatment compared with percutaneous coronary intervention or other surgeries. Because of plentiful flow of the right coronary artery, we decided to use a vein graft to avoid competitive flow. Postoperative coronary angiography revealed intact flow in both the native coronary artery and the vein graft 1 year after the surgery. The myocardial ischemia seen on scintigraphy and the
chest pain
had disappeared.
Gen
Thorac Cardiovasc Surg 2009 Mar
PMID:Advantage of vein grafts for anomalous origin of a right coronary artery. 1928 Mar 10
Aortic stenosis is now the most common type of valvular heart disease in Europe and North America. Calcific aortic stenosis affects 2-7% of people aged over 65 years. Dyspnoea,
chest pain
, and syncope require investigation and surgery is the preferred option for suitable individuals. Operative mortality is 3-5% for those aged under 70 years and 5-15% in older adults. The case reported here illustrates the issues raised when a GP's patient unexpectedly collapses in a public place and other professional agencies become involved. Relevant UK medico-legal requirements of the vehicle licensing agency and the new guidance related to antibiotic prophylaxis and heart valve disease are also discussed.
Br J
Gen
Pract 2009 Apr
PMID:Aortic stenosis and the case of the missing handbag. 1934 55
Early-stage malignant pleural mesothelioma (MPM) is difficult for physicians to diagnose, and the disease is usually advanced at the time of diagnosis. We report a case of early-stage MPM in a 69-year-old man. The patient presented with fever and left
chest pain
. A computed tomography scan (CT) of the chest showed a small amount of left pleural effusion and slight left pleural thickening that remained unchanged for 1 year. One month after his inflammatory response spontaneously decreased, follow-up CT of the chest showed reduction in the effusion volume but no change in the pleural thickening. Positron emission tomography with (18)F-fluorodeoxyglucose (FDG) showed increased FDG uptake in the pleural thickening on the left side. Because MPM could not be ruled out, video-assisted thoracoscopic surgery with pleural biopsy was performed for a definitive diagnosis. The postoperative histological diagnosis was early-stage MPM classified as T1a N0M0 disease.
Gen
Thorac Cardiovasc Surg 2009 May
PMID:Stage Ia malignant pleural mesothelioma: clinical course and appropriate diagnostic process. 1944 Aug 26
Although there are many reports of spontaneous regression of noninvasive thymoma, there are no reports of spontaneous regression of an invasive thymoma. Moreover, the mechanism of the spontaneous regression is still unknown. The present case concerns a 47-year-old man who presented with
chest pain
. Computed tomography (CT) showed a large anterior mediastinal mass with left pleural effusion that occluded the innominate vein. The tissue obtained by video-assisted thoracic surgery suggested a diagnosis of invasive thymic carcinoma. One month later CT showed prominent regression of the tumor, and the tumor was completely resected. On pathology, the diagnosis was thymoma type B3.
Gen
Thorac Cardiovasc Surg 2009 May
PMID:Spontaneous regression of an invasive thymoma. 2040 19
Hyperbaric oxygen treatment (HBO) could transiently reverse hypoxia during acute myocardial infarction (AMI). In order to evaluate whether early HBO can identify viable segments after AMI, improvement of wall motion score index (WMSI) after HBO was compared to dobutamine stress echocardiography (DSE). Thirty-one patients with first AMI treated with thrombolysis received 100% oxygen at 2 technical atmospheres for 1 h within 24 h of the onset of
chest pain
. All patients underwent echocardiography before and after HBO and during DSE. Improvements in WMSI after HBO, as well as during DSE were considered as proof of viability. Total of 186 akinetic segments were detected before HBO. Functional recovery was defined at 73 after HBO and 113 segments were fixed. Eighty-one segments improved contraction with DSE. WMSI improved before HBO compared to the one after HBO (1.79 vs. 1.65, p = 0.024) and DSE (1.79 vs. 1.60, p < 0.001). Close relationship between WMSI after HBO and DSE was found (r = 0.417, p = 0.022). Sensitivity and specificity of HBO for viability were 73% and 85%, respectively. HBO may identify viable myocardium as early as day one after AMI. The highest number of responding segments was detected in patients who received HBO within shortest intervals following the onset of
chest pain
.
Gen
Physiol Biophys 2009
PMID:Early detection of myocardial viability by hyperbaric oxygenation in patients with acute myocardial infarction treated with thrombolysis. 1989 90
We report a case of a mediastinal teratoma associated with acute mediastinitis that required an emergency operation. These tumors cause a variety of complications, but reports of acute mediastinitis are rare. A 24-year-old woman was admitted to our hospital for complaints of
chest pain
and fever and was subsequently diagnosed as having an anterior mediastinal tumor. Follow-up computed tomography showed rapidly progressing acute mediastinitis, which was diagnosed as a perforation of the teratoma. We performed emergency surgical extirpation of the tumor and mediastinal drainage. The histopathologic diagnosis was a mature teratoma that included pancreatic tissue. Although the apparent site of the rupture was not obvious, there was a wide area of acute inflammation in the mediastinal adipose tissue. The patient did well and was discharged from the hospital without major complications.
Gen
Thorac Cardiovasc Surg 2010 Feb
PMID:Mediastinal teratoma complicated with acute mediastinitis. 2015 50
A coronary artery aneurysm is uncommon and frequently asymptomatic. This report presents a surgical case of a giant coronary artery aneurysm complicated by acute myocardial infarction. A 26-year-old man with sudden
chest pain
was referred to our hospital. Myocardial infarction was suspected, and emergency coronary angiography was performed. A giant coronary aneurysm was found in the mid-portion of the right coronary artery. The aneurysm, which was thrombosis-occluded, was successfully resected, and the right coronary artery was anastomosed in an end-to-end fashion. Although the strategy for treating a coronary artery aneurysm without myocardial ischemia remains controversial, surgical intervention should be considered in cases with a giant coronary artery aneurysm, even if asymptomatic, provided the surgical risk is low.
Gen
Thorac Cardiovasc Surg 2010 Apr
PMID:Giant right coronary artery aneurysm complicated by acute myocardial infarction. 2040 12
A 16-year-old boy was hospitalized for fever,
chest pain
, and cardiovascular collapse. Transthoracic echocardiography revealed a 30-mm circumferential echogenic "porridge-like" pericardial effusion with signs of cardiac tamponade. Tuberculosis (TB) was suspected because of its prevalence in Djibouti. Emergency pericardiocentesis was attempted, but only 10 ml of pericardial fluid was obtained. Subxiphoid pericardiotomy and drainage were then performed, and pericardial fibrinous pockets were surgically collapsed. Antituberculosis chemotherapy was given, and the pericardial effusion progressively disappeared without corticosteroids. The diagnosis of TB was subsequently confirmed by cultures of the pericardial fluid. A pericardial biopsy was normal. After 3 months of follow-up, there was no sign of constrictive pericarditis. Pericardiocentesis may fail in cases of advanced-stage fibrinous TB pericardial effusion. Thus, pericardiotomy with complete open draining is the only lifesaving procedure.
Gen
Thorac Cardiovasc Surg 2010 Jun
PMID:Porridge-like tuberculous cardiac tamponade: treatment difficulties in the Horn of Africa. 2054 56
Mediastinal teratomas are typically benign and asymptomatic, but they undergo sudden enlargement or rupture into neighboring organs in some patients owing to intratumoral hemorrhage, leading to serious complications. We report the case of a mediastinal mature teratoma that was discovered because of the sudden onset of
chest pain
accompanied by elevated preoperative serum CA19-9 levels. The patient was a 43-year-old man who experienced sudden
chest pain
and was brought to hospital in an ambulance. Chest radiography and computed tomography revealed a mediastinal tumor and a serum CA19-9 level that was elevated to 4377 U/ml. The tumor comprised soft tissue, fluid, and cystic components. The histological diagnosis was mature teratoma with peritumoral bleeding. Most epithelial components, including squamous epithelium and similar components in the bronchi, showed positive results for CA19-9 on immunohistological examination. The postoperative course was uneventful, and serum CA19-9 levels normalized.
Gen
Thorac Cardiovasc Surg 2010 Jun
PMID:Resection of a mediastinal mature teratoma diagnosed owing to sudden chest pain with elevated preoperative serum CA19-9. 2054 62
A 65-year-old woman with a 9-year surgical history of a left breast phyllodes tumor was admitted with progressive
chest pain
on effort. Computed tomography showed severe stenosis of the main pulmonary artery, with the mass originating from the ventricular septum. We planned to resect the tumor the next day. However, the next morning a pulmonary artery embolism occurred, and she developed dyspnea and lost consciousness. After carrying out cardiopulmonary resuscitation, we performed a life-saving operation. We successfully resected the huge tumor as far as possible from the right ventricle via a right atrial (RA)-tomy. However, her consciousness did not improve to better than Glasgow Coma Scale grade 7. She died from suffocation caused by metastasis invading her airway despite undergoing tracheotomy on the 77 th postoperative day.
Gen
Thorac Cardiovasc Surg 2010 Aug
PMID:Pulmonary artery obstruction due to a metastatic malignant phyllodes tumor of the breast. 2070 65
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