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Query: UMLS:C0476273 (respiratory distress)
 19,632 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Varicella pneumonia during pregnancy may be relatively mild or rapidly fatal. Diagnosis is based on the usual criteria for varicella in association with signs and symptoms of respiratory distress: dyspnea, tachypnea, cough, chest pain, and hemoptysis, with characteristic x-ray findings. Treatment should be directed toward maintaining blood oxygen saturation at as near normal as possible (monitored by serial blood gas determinations). The occurrence of congenital varicella is unpredictable, but an infant born within four days of the mother's development of the varicella skin rash is at high risk, with the outcome being fatal in five percent of cases.
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PMID:Varicella pneumonia during pregnancy. 42 71

Four patients had acute dyspnea and chest pain due to primary neurologic disease, not to cardiac or pulmonary disorders. They suffered from severe, involuntary respiratory dyskinesias, which resulted in an irregular respiratory rate, shortness of breath, and chest discomfort. These respiratory dyskinesias occurred as one aspect of more generalized choreiform movement disorders. Three patients had neuroleptic-induced tardive dyskinesias, and one had levodopa-induced dyskinesias. As a result of their ages and the nature of their complaints, some of these patients were originally thought to have cardiac and pulmonary disorders. Respiratory dyskinesias should be considered as a possible cause of respiratory distress in patients with extrapyramidal dysfunction.
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PMID:Respiratory dyskinesias: extrapyramidal dysfunction and dyspnea. 62 94

Primary liposarcomas of the mediastinum are very rare tumors. We record herein the fiftieth documented case, and the sixth in which there was evidence of superior vena caval obstruction. All previously reported cases have been studied; their salient clinical and pathological features have been tabulated. Review of these case reports reveals that the majority of patients have complaints of respiratory distress or chest pain. Other common presenting complaints include cough and weight loss. These tumors grow to an enormous size, and symptoms are referable to compression of contiguous intrathoracic structures. Radiotherapy or chemotherapy or both are ineffective theraputic modalities. The treatment of choice is surgical in all cases. Such an approach serves to establish a tissue diagnosis, to relieve the patient's symptoms, and may at times result in a cure.
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PMID:Primary liposarcoma of the mediastinum. Report of a case and review of the literature. 87 45

A 16 year old teenager with chest pain came to the emergency room at Children's Hospital in Charleston, South Carolina. Her sharp, constant midsternal pain and breathing difficulties began the morning of admission. 1 week before admission, she experienced a similar but less intense pain which resolved spontaneously. She was taking low-dose, triphasic oral contraceptives (OCs) as treatment for severe dysmenorrhea and dysfunctional uterine bleeding. She had no family history of elevated lipids, blood or clotting disorders, and cardiovascular disease. She did not smoke. She was obese (137.3 kg). She had elevated blood pressure (147/33 mm Hg), a high low-density lipoprotein count (140 mg/dL), and a high total cholesterol count (237 mg/dL). Her tender right calf was larger than the left calf. She had decreased perfusion of the entire left lung and right lower lobe. A pulmonary angiogram revealed emboli, and ultrasound of the legs revealed a thrombus behind the right knee. The physicians discontinued the OCs. They administered 2 anticoagulants--intravenous heparin followed by oral sodium warfarin for 6 months. Her respiratory distress ended within several days. Her right calf was no longer tender after 1 week. The physicians discharged her on a low-cholesterol, low-fat diet. They suggested she reduce her weight and exercise more often. She did not experience another venous thrombosis or pulmonary embolus. It appeared that the OCs contributed to her thromboembolism; yet, she did lead a sedentary lifestyle and was considerably overweight. Even though thromboembolism is rare in adolescents with no underlying predisposition for cardiovascular disease and who do not smoke, physicians should watch for sizeable changes in blood pressure, lipids, and cholesterol level as well as symptoms of deep venous thrombosis and cardiovascular disease.
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PMID:Pulmonary embolus in an adolescent on oral contraceptives. 129 Jul 74

Three cases of cardiotoxicity manifested by chest pain, tachycardia, respiratory distress, and electrocardiographic changes simulating acute myocardial infarction or ischemia were observed during the course of combination chemotherapy with etoposide, cisplatin, and continuous infusion of 5-fluorouracil in patients with advanced non-small cell lung cancer. There was no cardiac enzyme elevation. A similar but rare clinical syndrome has been described in association with 5-fluorouracil infusion as a single agent or in combination with other chemotherapeutic agents. We describe the cases and review their possible pathogeneses and clinical implications.
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PMID:Electrocardiographic changes simulating acute myocardial infarction or ischemia associated with combination chemotherapy with etoposide, cisplatin, and 5-fluorouracil. 209 95

In a medical emergency, when rapid diagnosis is essential, a thorough examination of the skin often provides clues to the underlying illness. Dermatologic lesions may suggest the etiology of common medical emergencies, such as coma, seizure, shock, chest pain, hemorrhage, respiratory distress, acute abdomen and acute psychosis. Since examination of the skin is rapidly and easily performed, it should be included in the evaluation of a patient with a medical emergency.
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PMID:Skin clues to medical emergencies. 240 77

Nitrofurantoin is a widely prescribed antibiotic used for the treatment of urinary tract infections. In some patients it can produce an acute pulmonary reaction ranging from mild dyspnea to noncardiogenic pulmonary edema. Symptoms include fever, dyspnea, chills, cough, and chest pain. Physical examination generally reveals an acutely ill, extremely apprehensive patient in varying degrees of respiratory distress. Fever is usually present and there is an increase in heart rate and respiratory rate. Cyanosis, rales, and a maculopapular rash are common findings. Laboratory studies typically demonstrate a leukocytosis with eosinophilia, varying degrees of hypoxia and hypocapnia, and a mild to moderate elevation of the erythrocyte sedimentation rate. The chest x-ray study may be normal but more often demonstrates bilateral lower lobe interstitial infiltrates frequently accompanied by pleural effusions. Treatment in the majority of cases requires only stopping the drug, but steroids, bronchodilators, or antihistamines may be used in selected cases. Once the diagnosis is made and the drug withdrawn, prognosis for full recovery is excellent.
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PMID:Acute pulmonary toxicity to nitrofurantoin. 270 84

Because the initiation of IV lines by emergency medical technicians-Intermediates (EMT-Is) appeared to delay the patient's transport to the hospital, we undertook a retrospective study of 370 patients to compare prehospital care rendered by EMTs (EMT-A equivalent) and EMT-Is in a rural setting. Our study was limited to acute medical conditions in which protocols called for IV lines (124 patients with chest pain, 122 with acute respiratory distress, 99 with seizures, and only 25 with cardiac arrest) (the cardiac arrest cases were too few for statistical significance). We found that the difference in scene times for EMTs and EMT-Is not attempting IV lines was 6.1 and 6.9 minutes, respectively. The average scene time of EMT-Is attempting an IV line was 19.6 minutes (P less than .001) compared with EMT times, or times for EMT-Is not attempting an IV line. One hundred twenty-eight of 370 patients received IV medication within ten minutes of arrival in the emergency department, and ten of these patients had their IV lines initiated successfully in the field. Thirty-nine percent of patients with ED IV lines received IV medication within ten minutes of arrival, while only 21% of patients with a field IV line received medication in this period (P less than .05). We conclude that initiating a field IV line in this specific patient population significantly increased scene time and did not improve the chances of these patients receiving IV medication within ten minutes of arrival in the emergency department.
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PMID:Prehospital care by EMTs and EMT-Is in a rural setting: prolongation of scene times by ALS procedures. 271 61

The records of 50 patients with traumatic aortic rupture (Group I) and 50 patients with blunt chest trauma but negative aortograms (Group II) were reviewed retrospectively. Symptoms and signs referable to the chest and thoracic aorta were recorded and compared in Group I and Group II patients. Each patient's chart was evaluated for chest pain, respiratory distress, thoracic back pain, hypotension, hypertension, and decreased femoral pulses. None of the symptoms or signs attained statistical significance between Group I and Group II patients. The only significant difference between Group I and Group II patients was in the injury severity score (ISS). The mean ISS for aortic rupture patients was 42.1 +/- 11.6 (SD), but was only 19.9 +/- 11.4 (SD) (P less than .001) for patients without aortic rupture. We conclude that the diagnosis of aortic rupture in patients sustaining blunt chest trauma cannot be accurately predicted or excluded on the basis of the patients' presenting complaints or physical findings.
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PMID:Significance of symptoms and signs in patients with traumatic aortic rupture. 647 10

This report describes a patient with a foreign body esophageal perforation in whom the usual clinical symptoms of respiratory distress and severe chest pain as well as obvious abnormalities on x-rays of the chest and esophagus were not present. The possible subtle nature of esophageal perforation is emphasized and the evaluation of such cases is reviewed.
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PMID:Esophageal foreign body perforation: report of an unusual case and review of the literature. 674 4


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