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Query: UMLS:C0149520 (acute cholecystitis)
 2,784 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The syndrome of abdominal fullness and nausea, diaphoresis, chest pain, and ECG changes long has been associated with impending myocardial infarction. For a few patients, however, a working diagnosis of coronary ischemia is seen to be inaccurate on further testing, including stress testing and cardiac catheterization. Acute cholecystitis may cause a clinical picture similar to that of cardiac ischemia. The ECG changes that may occur in acute cholecystitis, the possible basis for these changes, and their clinical implications are discussed in this article.
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PMID:Electrocardiographic changes in acute cholecystitis. 274 79

Acute elevation of the ST segment in several ECG leads was observed in seven patients with bacterial shock during the course of therapy. Six patients had bacterial pneumonia, one had acute cholecystitis, and none had a previous history of heart disease. At the onset of the ST elevation, all patients were receiving dopamine infusion, which in four of them was inadvertently increased shortly before the ECG changes, the ST elevation was not associated with chest pain, pericardial friction rub, or acute changes in the heart rate, or arterial blood pressure. In four patients the maximum ST elevation was greater than or equal to 5 mm. In each instance the ST segment returned to the isoelectric line within 24 hours, and subsequent development of Q waves or changes in the QRS was not observed. Although the existence of an acute pericarditis or an acute myocarditis as possible causes of the ST elevation cannot be fully ruled out, the sudden onset, prominent magnitude, and brief duration of the ST elevation are perhaps more indicative of an acute ischemic event, possibly related to a transient coronary vasoconstriction induced by the dopamine infusion.
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PMID:Acute and transient ST segment elevation during bacterial shock in seven patients without apparent heart disease. 706 10

Blood samples obtained from 97 consecutive patients admitted to the hospital for chest pain were analyzed for taurine concentrations. The mean value of the maximum taurine concentration in whole blood from AMI patients were greater than the mean value of the maximum taurine concentration in patients without AMI. There was no difference in plasma taurine levels between AMI and non-AMI patients, indicating that a cellular component(s) of whole blood was sequestering taurine. The increased blood taurine concentrations in the AMI patients evolved over the course of 70 hr and paralleled the increase in total CK levels. Blood taurine concentrations, in general, did not rise in patients who had chest pain of unknown etiology, skeletal muscle trauma, pleuritic pain, SVT/VT plus CV, acute pericarditis, acute cholecystitis, or angina pectoris. It is concluded that blood but not plasma taurine concentrations rise after acute myocardial injury and tend to be higher the more extensive the infarction. The mechanism of the blood taurine rise is unknown, but a myocardial source is probable. Also, there is evidence that the myocardium selectively leaks taurine, and not other amino acids. Monitoring blood taurine concentration in AMI may provide useful diagnostic and prognostic information.
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PMID:Elevated blood taurine levels in acute and evolving myocardial infarction. 731 Feb 26

That abdominal distention, nausea, and chest pain may be accompanied by ischemic ECG changes is well known and has been described in the literature. However, very few cases have been reported with acute cholecystitis and ECG changes not due to cardiac ischemia. We present a previously healthy 20-year-old woman admitted with acute cholecystitis. Prior to surgery routine ECG showed ST-depression and T-wave inversion. The day following cholecystectomy the ECG returned to normal. 1 month later, ergometry and echocardiography were both negative. Based on the literature and our personal experience, although ECG changes may occur in acute cholecystitis, the possibility of cardiac ischemia must be excluded. However, when no cardiac basis is found, ultrasound of the biliary system might reveal the cause of these ECG changes. Thus, in acute cholecystitis with ischemic ECG changes but no other laboratory or clinical evidence of cardiac ischemia, ECG changes alone are not a contraindication to cholecystectomy. Furthermore, delay in treatment could be harmful.
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PMID:[Transient ischemic ECG changes in a patient with acute cholecystitis without a history of ischemic heart disease]. 1088 57

Coronary atherosclerosis, myocardial bridge, and coronary aneurysm are different causes of myocardial ischemia. Patients with cardiac ischemia can be complicated by acute cholecystitis. A 39-year-old man referred with chest pain and cold sweating and scheduled for coronary artery bypass grafting (CABG) because of severe stenosis in right coronary artery, aneurysm of left circumflex artery, and long-segment muscle bridge in the middle part of left anterior descending artery. He developed acute cholecystitis before operation. Concomitant cholecystectomy and CABG was done. He is the first patient with three different coronary pathologies and simultaneous cholecystitis in the English-language literature who was operated on in a single session.
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PMID:Triple coronary pathologies complicated by acute cholecystitis. 2037 94

Although the decision to use nuclear medicine (NM) modalities in the acute care setting is limited by several factors, there are instances in which the use of NM techniques can provide elegant and efficient solutions to otherwise expensive and resource consuming situations. Herein, we describe the indications and NM techniques used for the evaluation of low-risk patients with chest pain, suspected pulmonary embolus, acute cholecystitis, gastrointestinal bleeding, acute scrotum, and the radiographically occult fracture.
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PMID:Diagnostic nuclear medicine in the ED. 2082 18

Although chest pain with ST-segment elevation is often indicative of cardiac ischemia, it has also been described with surgical conditions such as acute cholecystitis. We report the case of a 34-year-old Caucasian female who was referred with symptoms consistent with acute cholecystitis. An electrocardiogram (ECG) showed unexpected changes with inferolateral ST-segment elevation indicative of an inferolateral myocardial infarct. Further investigations and analysis of the results along with the clinical picture meant an acute cardiac event was excluded. Gallstones were seen on ultrasound and an inflamed gallbladder, consistent with acute cholecystitis, was confirmed at laparoscopic cholecystectomy. This led to the resolution of her symptoms and a return to the isoelectric baseline of the ST segments on the ECG. Five previous cases of cholecystitis induced ECG changes have been described in the literature. This case describes the youngest patient with no previous cardiac disease. We review the literature and suggest the pathophysiological mechanism to explain these findings. When the initial diagnostic interventions for chest pain with ST-segment elevation do not yield the expected results, an alternative diagnosis such as cholecystitis should be considered.
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PMID:Acute cholecystits leading to ischemic ECG changes in a patient with no underlying cardiac disease. 2190 54