Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a prospective study of children with the primary complaint of chest pain, 43 patients were identified. This gave an occurrence (per patient visits) of 0.288%. The average age was 12.9 years for boys and 11.80 years for girls. Diagnostic categories identified were idiopathic chest pain (45%), costochondritis (22.5%), chest pain secondary to bronchitis (12.5%), miscellaneous (10%), chest pain secondary to muscle strain (5%), and chest pain secondary to trauma (5%). These six categories are discussed in terms of age, sex, resolution of symptoms, duration of the complaint, return for follow-up examination, quality of pain, psychiatric profile, and results of laboratories studies. It is concluded that chest pain in children is not as ominous a symptom as it is in adults, and that it infrequently signals underlying cardiac disease or other serious disease that is not apparent from a thorough history and physical examination.
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PMID:Chest pain in children: a prospective study. 94 Jul 5

Seventeen patients presenting with anginal-type pain were studied by bicycle exercise testing, rapid atrial pacing, and coronary angiography. Ten patients with angina and abnormal pacing tests at rates less than 180/minute were found to have significant coronary artery disease as demonstrated by coronary angiography. Seven patients with pacing-induced chest pain only at rates of 180 and above had normal coronary angiogram. This suggests that patients requiring rates of 180 or more to produce a positive atrial pacing test, following our protocol, do not usually have significant coronary artery disease though confirmation requires a larger study.
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PMID:Evaluation of rapid atrial pacing in diagnosis of coronary artery disease. Evaluation of atrial pacing test. 97 85

The cases of six patients are reported illustrating that chest pain may be a prominent feature of sarcoidosis. It may be severe and be the chief presenting symptom. In the cases described it was mostly retrosternal and had few consistent aggravating factors. In each case there was bilateral hilar lymph node enlargement and it is suggested that htis was chiefly responsible for this relatively uncommon symptom of sarcoidosis. It is also suggested that undue persisting pain may respond to corticosteroid administration.
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PMID:Chest pain in the presentation of sarcoidosis. 99 Jan 61

In a series of 63 patients, 60 with angina pectoris and 3 with cervical spondylosis and "thoracic spondylosis" showing angina like pain detailed assessments were made of the mode of onset of attack, including electrocardiography during attacks, X-ray examination of the thoracic and cervical vertebrae and neurological examinations, along with coronary arteriography in some cases, with the following results: 1. The cases of angina pectoris were classifiable grossly into two groups according to mode of onset of chest pain: Group A: Angina began with pain in the anterior chest (39 cases); Group B: Angina in the anterior chest was preceded by "pain" occurred elsewhere in the chest (21 cases). The cases in group B were further classified under two categories, types BI and BII, the former being characterized by a sudden onset of "pain" in a somatic area or areas other than the anterior chest where there is usually no dysesthesia, followed by development of retrosternal or precordial pain (6 cases), while the latter type of angina began with paroxysmal exacerbation of preexistent dysesthesia in the nape, shoulder and arms and eventuated in pain in the anterior chest (15 cases). There were two subtypes in the type BII angina viz. types BIIa and BIIb. There was no ECG evidence of ischemic changes at exacerbation of the nucha-omo-brachial dysesthesia in type BIIa while significant ischemic ECG changes were evident in association of aggravation of dysesthesia in the type BIIb patients. 2. Concomitant "cervical spondylosis" with radiographic evidence of abnormalities in cervical vertebrae and associated subjective symptoms accounted for 22.9% of group A and for 71.4% of group B. In no case of type BI was there evidence of such complication whilst all the cases of type BII had this complication. 3. The mode of appearance of pain in patients with cervical spondylosis showing angina like pain resembled to that of angina pectoris in type BII but ECG during attack did not reveal any significant ischemic changes. 4. As for interrelation between findings by selective coronary angiography (26 cases of angina pectoris) and complication of "cervical spondylosis", the complication of "cervical spondylosis" was higher in incidence in the group of cases with low-grade coronary arterial changes (degree of occlusion less than 50%) than in the group with greater arterial changes (degree of occlusion over 50%). The findings described suggest the possibility that the mode of manifestation of anginal attack may be modified by the concomitant presence of "cervical spondylosis".
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PMID:Clinical analysis of angina pectoris and angina-like pain --With special reference to ECG during attack, "cervical spondylosis" and selective coronary arteriography. 99 8

To clarify the association between chest pain and significant coronary artery disease in patients who have aortic valve disease, 76 consecutive candidates for aortic valve replacement were evaluated prospectively with use of a historical questionnaire and coronary arteriography. Of the 76 patients, 19 (25 percent) had no chest pain, 21 (28 percent) had chest pain that was not typical of angina pectoris and 36 (47 percent) had chest pain typical of anigina pectoris. In 18 of 19 patients the absence of chest pain correlated with the absence of coronary artery disease. The single patient without chest pain who had coronary artery disease had evidence of an inferior myocardial infarction in the electrocardiogram. Thus, absence of chest pain and the absence of electrocardiographic evidence of infarction predicted the absence of coronary disease in all cases. The presence of chest pain did not predict the presence of coronary artery disease, but the more typical the pain of angina pectoris the more likely were patients to have significant coronary artery disease. Of the 21 patients with atypical chest pain, 6 (29 percent) had coronary artery disease, but of the 36 patients with typical angina pectoris 23 (64 percent) had significant coronary artery disease. In addition, when patients with chest pain not typical of angina pectoris also had coronary artery disease, the diseased vessels usually supplied smaller areas of the left ventricle than when the pain was typical of angina pectoris. In 21 of 23 patients (91 percent) with typical angina pectoris and significant coronary artery disease, lesions were present in the left coronary artery. There was no systolic pressure gradient across the aortic valve that excluded the presence of coronary artery disease, although all patients with a calculated aortic valve area of less than 0.4 cm2 were free of coronary artery disease. Patients with severe left ventricular dysfunction were more likely to have normal coronary arteries.
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PMID:Chest pain as a predictor of coronary artery disease in patients with obstructive aortic valve disease. 99 22

Sixty patients with chest pain, chest and epigastric pain, or predominantly epigastric pain, not explained by electrocardiographic (EKG) changes or pulmonary findings, were given 20 cc of Xylocaine Viscous orally. Thirty-seven out of 60 experienced complete or almost complete relief within 10 to 15 minutes. Of this group, none were found to have suffered a myocardial infarction. Of the 23 patients who did not experience pain relief, six had a myocardial infarction and seven were diagnosed as having cardiac angina. Determination of serum lidocaine levels after oral ingestion of 20 cc of Xylocaine Viscous in patients with normal gastric function demonstrated a maximum level of 0.55 mu/ml--a serum level unlikely to result in adverse side effects.
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PMID:Xylocaine viscous as an aid in the differential diagnosis of chest pain. 101 76

Although destructive bone disease is a well-known complication of tertiary syphilis, osteitis or osteomyelitis are not commonly recognized as complications of early (primary or secondary) syphillis. A patient with secondary syphilis characterized by generalized lymphadenopathy, perianal condyloma lata, and positive rapid plasma reagin (RPR) and fluorescent treponemal antibody-absorption (FTA-ABS) tests also complained of headache, right should pain, and right anterior chest pain and swelling. Roentgenograms showed mottled osteolytic lesions consistent with previously described luetic bone disease. Biopsy confirmed the diagnosis of syphilitic osteomyelitis, and treatment with penicillin resulted in prompt resolution of symptoms.
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PMID:Destructive bone disease in early syphilis. 103 40

A patient with a myofascial pain-dysfunction (MPD) syndrome with pain radiating into the chest has been described. A direct relationship between a dental malocclusion and the chest pain was confirmed by tests. The patient was treated for MPD syndrome related to the malocclusion, and the chest pain symptoms were relieved. This report demonstrates the need for the dentist to consider not only the muscles of mastication in the management of problems of the neuromuscular apparatus but also the delicate balance which exists between the masticatory apparatus and the postural muscles of the head and neck.
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PMID:Chronic myofascial pain-dysfunction syndrome with chest pain. 105 14

A case is reported in which initial anginal pain was localized to the area of the left posterior teeth. Subsequently the patient reported that at certain times he experienced pain in the area of the left posterior teeth with concomitant chest pain while at other times the pain was confined to the teeth.
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PMID:Anginal pain referred to the teeth. Report of a case. 105 65

Systolic time intervals and the a/H ratio were recorded in 20 patients with uncomplicated acute myocardial infarction over a period of five days. The initial high heart rate and systolic blood pressure and the short PEP and ICT indicating a sympathetic overactivity were spontaneously normalized during the first week of infarction. LVET was reduced indicating a fall in stroke volume and the a/H ratio was unchanged at the high levels suggestive of elevated preload or LVEDP. In 10 patients with acute myocardial infarction and recurrent chest pain recordings on noninvasive parameters were made before and 30 min after intravenous injection of practolol. In addition, 7 patients with chest pain, classified as acute myocardial infarction, were given practolol. The average dose of practolol was 17.9 mg ranging from 5 to 30 mg. An almost immediate and pronounced relief of pain was observed in all patients and no signs of impaired left ventricular function appeared. The product of systolic blood pressure and heart rate was decreased by practolol and the PEP and the ICT were prolonged to normal values while no changes were seen in LVET and a/H ratio. On 126 occasions practolol was given in dosages ranging from 5 to 30 mg (mean 8 mg) to 75 patients with acute myocardial infarction and recurrent chest pain. A satisfactory pain relief was seen on 108 occasions. It is suggested that an inappropriate sympathetic overactivity is an important factor in provoking recurrent chest pain in acute myocardial infarction. Administration of the beta-adrenergic blocking agent practolol resulted in pain relief due to reduction of heart work and in severity of myocardial ischemia. The beta-blocking agent was well tolerated in the present study. Continuous beta-blockade during the whole hospital stay to patients with acute myocardial infarction seems to be a very attractive therapy in order to preserve the ischemic myocardium and limit the size of infarction.
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PMID:Effect of cardioselective beta-blockade on heart function and chest pain in acute myocardial infarction. 106 28


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