Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0008031 (chest pain)
 17,248 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A case of schwannoma of the cervical spinal cord presenting with cervical angina is reported. A 49-year-old man was admitted to our hospital with severe chest pain, cold sweats, and unconsciousness. Extensive cardiac examination showed no abnormal findings. Neurological deficits were muscular weakness and atrophy of the left arm, bilateral hypersthesia of the arms, and hyporeflexia of the left biceps. MRI revealed a tumor in the left side of the spinal canal between C4 and C5. The diagnosis was neurinoma of the left nerve root in C5. The tumor was completely removed surgically by laminectomy. Surgery confirmed that the tumor had originated from the left posterior root of C5 and that, histologically, it was schwannoma. The severe chest pain immediately disappeared after removal of the tumor with only dull post-operative chest pain remaining. We hypothesized that the severe chest pain was protopathic pain caused by compression of the anterior C5 root by the tumor and/or disturbance of the inhibitory pain mechanisms of the sympathetic nerve located in the posterior horn of the spinal cord. It must be kept in mind that cervical angina caused by spinal schwannoma is one of the differential diagnoses of chest pain.
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PMID:[Schwannoma of the cervical spinal cord with cervical angina: a case report]. 1151 5

Metallic devices generally represent a contra-indication for MRI scanning. Based on laboratory testing, the neuro cybernetic prosthesis (NCP) is labelled MRI compatible when used with a send and receive head coil. However, there are no published clinical data to support the safety of brain MRI in patients with the NCP. Our objective was to report clinical experience with such a population. We questioned 40 centres that had implanted the NCP system as of 10/1/99. If MRI had been performed on any vagus nerve stimulator patients, we collected information on these patients, the MRI technique used, any events noted during the scan, including both subjective reports (by the patient ), and observable (objective) changes noted by the staff. Twelve centres (30%) responded. Over a time period of 3 years, there were a total of 27 MRI scans performed in 25 patients. All scanners were 1.5 T. A head coil was used in 26 scans, and a body coil in one. The indications for the scans were diverse. Seven were related to the epilepsy, including aetiology or pre-surgical evaluation. Others were unrelated, including brain tumours, cerebral haematoma, vasculitis, headaches, and head trauma. Three scans were performed with the stimulator on, while 24 were performed with the stimulator off. One patient had a mild objective voice change for several minutes. No other objective changes were noted in any of the patients. One 11-year old reported chest pain while experiencing severe claustrophobia. Twenty-five patients denied any discomfort around the lead or the generator. We conclude that this clinical series supports the safety of routine brain MRI using a send and receive head coil in patients implanted with the NCP System.
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PMID:MRI of the brain is safe in patients implanted with the vagus nerve stimulator. 1174 9

A 74-year-old woman was admitted to our hospital because of right chest pain. The chest radiograph showed right hilar pulmonary artery dilatation. A mass exhibiting low intensity in T1-weighted images and high intensity in T2-weighted images was disclosed in the right pulmonary artery. Because of its clinical course and the MRI findings, the mass was thought to be tumorous tissue, and so pneumonectomy was performed. Leiomyosarcoma was diagnosed from the histological findings. Primary artery sarcoma is rare and the prognosis is considered to be extremely poor. The patient was successfully treated and had a good clinical outcome.
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PMID:[A case of primary leiomyosarcoma of the pulmonary artery]. 1182 28

The patient was a 57-year-old female with the main complaint of left chest pain and gait disturbance. Multiple bone metastases were observed in the vertebral and pelvic bone. Pathological pressure fracture, stegnosis of the spinal canal and edematous changes in the spinal nerves, especially in the 4th and 5th thoracic vertebrae, were observed. The clinical pathological status was T4cN1M1b, OSS Stage IV. After 4 cycles of weekly doxorubicin (DXR) (20 mg/body)/docetaxel (TXT) (40 mg/body) therapy (day 1, day 8, day 15, 1-week recovery period) were given to the patient, CA15-3 had decreased from 1,200 U/ml to 28 U/ml. The histopathological effect was judged to be Grade 2. Thereafter, ICTP was increased to 12.7 ng/ml and after 2 cycles of the weekly DXR/TXT therapy (day 1, day 8, 2-week recovery period) had been added, the patient was able to walk. MRI of the thoracic vertebrae showed that the foci of bone metastasis had improved 9 months after the treatment with chemotherapeutics, and good PS was maintained. No serious adverse reactions were observed with the weekly DXR/TXT therapy. Therefore, weekly DXR/TXT therapy is considered to be effective in treating patients with bone metastasis.
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PMID:[Patient with bone metastasis of breast cancer who were improved by weekly DXR/TXT therapy]. 1235 48

Type B aortic dissection involves the appearance of a false lumen distal to the left subclavian artery and extending distally into the descending thoracic aorta and into the abdominal aorta. Complications of the dissection include rupture of the thoracic aorta, leg ischemia, visceral ischemia, and renal failure. A 37-year-old man presented with complaints of sudden onset of chest pain, left leg pain, and numbness. Examination revealed no femoral, popliteal, or distal pulses with decreased sensory and motor function on the left lower extremity. A CT scan revealed an aortic dissection at the proximal descending aorta extending into the iliac arteries with a left retroperitoneal hematoma at the iliac bifurcation. An MRI confirmed the dissection distal to the left subclavian artery into the iliac artery with a distal occlusion. Exploration revealed rupture of the left iliac artery dissection with arterial occlusion and a contained hematoma. The common iliac artery was ligated and an 8-mm Dacron bypass graft from the right common femoral artery to the left femoral artery was performed. Type B aortic dissection can present as rupture of the common iliac artery. Revascularization of the extremity with a femoral-femoral crossover graft is the recommended procedure in the absence of visceral ischemia. The surgeon should have a keen suspicion of this rare complication and its management.
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PMID:Type B aortic dissection with rupture of the left common iliac artery: a case report. 1246 17

Lung cancer involvement of the heart is silent, carries a poor prognosis, and is most commonly identified at autopsy. A patient with lung cancer presented with symptoms and ECG findings suggestive of an acute coronary syndrome. Persistent symptoms and normal creatine phosphokinase (CPK) levels led to use of MRI and radionuclide scintigraphy to diagnose neoplastic infiltration of the myocardium. Palliative care was established with significant symptom relief. Assessment for cardiac metastases should be considered in patients with advanced lung cancer presenting with chest pain, new ECG findings, and normal CPK levels.
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PMID:Squamous cell lung cancer simulating an acute myocardial infarction. 1252 39

A patient with a history of bronchial carcinoma was admitted to the coronary care unit with chest pain suggestive of infarction and an ECG showing changes compatible with acute lateral wall infarction. The coronary arteries were shown to be normal and echocardiography revealed an intracardiac mass which MRI confirmed to be a direct extension of the pulmonary tumour. Echocardiography should be performed systematically in patients with chest pain and ECG changes of ischaemia who also have progressive oncological disease.
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PMID:[Metastasis stimulating a myocardial infarction]. 1261 52

Ruptured diaphragm as a result of blunt trauma can present acutely or late in the disease, process. Late presentation is often a result of herniation of abdominal contents into the thorax. Patients may present with nonspecific symptoms, and may complain of chest pain, abdominal pain, dyspnea, tachypnea, or cough. Clinicians must have a high index of suspicion for prompt diagnosis. Diagnostic tools include chest radiograph, CT scan, and MRI. The treatment for rupture of the diaphragm is surgical. The authors report a case of traumatic rupture of the diaphragm presenting 20 years after an automobile accident with blunt trauma to the abdomen.
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PMID:Delayed presentation of traumatic rupture of the diaphragm. 1273 6

A 4-year-old girl had repetitive attacks of chest pain, palpitation and loss of consciousness, which lasted for a few minutes and occurred several times a day. Interictal and ictal EEGs revealed that these episodes were complex partial seizures with autonomic symptoms originating from the right antero-temporal area. Brain MRI depicted a tumor in the right temporal lobe, the suspected etiology of the seizures. The tumor and its surrounding area were carefully resected using electrocorticogram. Pathologically, the tumor was diagnosed as an oligodendroglioma. MR spectrometry demonstrated a definite reduction of NAA/creatine ratio in the tumor. It is reported that a probability of developing seizures in cases of oligodendroglioma is about 80-90%. The occurrence rate of seizures in oligodendroglioma is much higher than that in other brain tumors. The cause of the epileptogenesis in oligodendroglioma might be due to the pathological tissue of satellitosis and secondary degeneration of neurons.
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PMID:[A case of oligodendroglioma with temporal lobe epilepsy initially suspected as having paroxymal tachycardia]. 1367 49

The medical history is the cornerstone of the diagnosis of chest pain. In presence of angina like symptoms, the diagnosis of coronary artery disease must be assertained by rest and exercise ECG, eventually coupled with a stress echo or scintigraphy. Coronary angiography remains the ultimate diagnostic procedure despite recent advances in CT scan or MRI technologies. Beside symptomatic treatment aiming to reduce metabolic demand by medication or to improve revascularisation by surgery or percutaneous intervention, the actual therapeutic approach involves therapies aiming to stop atherosclerosis such as strict correction of coronary risk factors, use of statines, ACE inhibitors and antiplatelet agents.
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PMID:[Angina]. 1518 25


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