The Prevalence of Abnormal Esophageal Test Results in Patients With Cardiovascular Disease and Unexplained Chest Pain

1990 ◽  
Vol 150 (5) ◽  
pp. 965 ◽  
Author(s):  
Edward G. Hewson
Keyword(s):  
Cardiovascular Disease ◽  
Chest Pain ◽  
Test Results ◽  
Esophageal Test

scholarly journals Towards an SI-Traceable Reference Measurement System for Seven Serum Apolipoproteins Using Bottom-Up Quantitative Proteomics: Conceptual Approach Enabled by Cross-Disciplinary/Cross-Sector Collaboration

2020 ◽  
Author(s):  
Christa M Cobbaert ◽  
Harald Althaus ◽  
Ilijana Begcevic Brkovic ◽  
Uta Ceglarek ◽  
Stefan Coassin ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Cardiovascular Disease ◽  
Measurement System ◽  
Protein Quantification ◽  
Test Results ◽  
Conceptual Approach ◽  
Reference Measurement ◽  
Lipid Panel ◽  
Mass Spectrometry Technology ◽  
Reference Measurement System

Abstract Current dyslipidemia management in patients with atherosclerotic cardiovascular disease (ASCVD) is based on traditional serum lipids. Yet, there is some indication from basic research that serum apolipoproteins A-I, (a), B, C-I, C-II, C-III, and E may give better pathophysiological insight into the root causes of dyslipidemia. To facilitate the future adoption of clinical serum apolipoprotein (apo) profiling for precision medicine, strategies for accurate testing should be developed in advance. Recent discoveries in basic science and translational medicine set the stage for the IFCC Working Group on Apolipoproteins by Mass Spectrometry. Main drivers were the convergence of unmet clinical needs in cardiovascular disease (CVD) patients with enabling technology and metrology. First, the residual cardiovascular risk after accounting for established risk factors demonstrates that the current lipid panel is too limited to capture the full complexity of lipid metabolism in patients. Second, there is a need for accurate test results in highly polymorphic and atherogenic apolipoproteins such as apo(a). Third, sufficient robustness of mass spectrometry technology allows reproducible protein quantification at the molecular level. Fourth, several calibration hierarchies in the revised ISO 17511:2020 guideline facilitate metrological traceability of test results, the highest achievable standard being traceability to SI. This article outlines the conceptual approach aimed at achieving a novel, multiplexed Reference Measurement System (RMS) for seven apolipoproteins based on isotope dilution mass spectrometry and peptide-based calibration. This RMS should enable standardization of existing and emerging apolipoprotein assays to SI, within allowable limits of measurement uncertainty, through a sustainable network of Reference Laboratories.

scholarly journals Clinical judgement in chest pain: a case report 

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Mishita Goel ◽  
Shubhkarman Dhillon ◽  
Sarwan Kumar ◽  
Vesna Tegeltija
Keyword(s):  
Chest Pain ◽  
Coronary Artery ◽  
Tobacco Use ◽  
Stress Test ◽  
Artery Bypass ◽  
Pretest Probability ◽  
Clinical Judgement ◽  
Test Results ◽  
Cardiac Stress ◽  
History Of

Abstract Background Cardiac stress testing is a validated diagnostic tool to assess symptomatic patients with intermediate pretest probability of coronary artery disease (CAD). However, in some cases, the cardiac stress test may provide inconclusive results and the decision for further workup typically depends on the clinical judgement of the physician. These decisions can greatly affect patient outcomes. Case presentation We present an interesting case of a 54-year-old Caucasian male with history of tobacco use and gastroesophageal reflux disease (GERD) who presented with atypical chest pain. He had an asymptomatic electrocardiogram (EKG) stress test with intermediate probability of ischemia. Further workup with coronary computed tomography angiography (CCTA) and cardiac catheterization revealed multivessel CAD requiring a bypass surgery. In this case, the patient only had a history of tobacco use but no other significant comorbidities. He was clinically stable during his hospital stay and his testing was anticipated to be negative. However to complete workup, cardiology recommended anatomical testing with CCTA given the indeterminate EKG stress test results but the results of significant stenosis were surprising with the patient eventually requiring coronary artery bypass grafting (CABG). Conclusion As a result of the availability of multiple noninvasive diagnostic tests with almost similar sensitivities for CAD, physicians often face this dilemma of choosing the right test for optimal evaluation of chest pain in patients with intermediate pretest probability of CAD. Optimal test selection requires an individualized patient approach. Our experience with this case emphasizes the role of history taking, clinical judgement, and the risk/benefit ratio in deciding further workup when faced with inconclusive stress test results. Physicians should have a lower threshold for further workup of patients with inconclusive or even negative stress test results because of the diagnostic limitations of the test. Instead, utilizing a different, anatomical test may be more valuable. Specifically, the case established the usefulness of CCTA in cases such as this where other CAD diagnostic testing is indeterminate.

scholarly journals 189 Prevalence of comorbidities and the incidence of cardiovascular disease in those with non-cardiac chest pain

2021 ◽  
Author(s):  
Sai Ramesh ◽  
Kayleigh Mason ◽  
James Bailey ◽  
Mamas Mamas ◽  
Kelvin Jordan
Keyword(s):  
Cardiovascular Disease ◽  
Chest Pain

scholarly journals Adherence and its impact on the reduction of lipid peril of patients seen in the form of telemedicine at a state university in Costa Rica

2015 ◽  
Vol 7 (2) ◽  
pp. 137-142
Author(s):  
Karla Rojas Suárez ◽  
Lourdes Rojas Espinoza
Keyword(s):  
Cardiovascular Disease ◽  
Costa Rica ◽  
Total Cholesterol ◽  
Age Groups ◽  
Costa Rican ◽  
State University ◽  
Test Results ◽  
Adherence To Treatment ◽  
Cholesterol Levels ◽  
Laboratory Results

Cardiovascular disease is the leading cause of morbidity and mortality worldwide. Costa Rica is no exception, with high levels of cholesterol and triglycerides in all age groups, and lack of adherence to treatment as one of the main challenges. We analyze the variation in test results of lipid pro le in one control and one telemedicine group in the staff of a Costa Rican university. We followed 62 patients aged 20-70 years, with tests done after fasting 12 hours, and 6 months to a year between samples. A questionnaire was used to calculate rates of factors that affect the variation in laboratory results. The patients had greater commitment to self care in the telemedicine group, achieving a reduction in total cholesterol levels, with little or no variation in other lipoproteins, and a slight increase in triglyceride levels.

Creatine kinase radioimmunoassay and isoenzyme electrophoresis compared in the diagnosis of acute myocardial infarction.

1980 ◽  
Vol 26 (7) ◽  
pp. 861-866 ◽  
Author(s):  
H A Homburger ◽  
G L Jacob
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Creatine Kinase ◽  
Chest Pain ◽  
Predictive Value ◽  
Positive Test ◽  
Test Results ◽  
Diagnostic Specificity ◽  
B Subunit ◽  
Creatine Kinase B

Abstract We compared, in 116 patients, the relative usefulness of results of tests for creatine kinase B isoenzymes, as measured by radioimmunoassay, and the MB isoenzyme, as measured by electrophoresis, in diagnosis of acute myocardial infarction. The radioimmunoassay was specific for isoenzymes of creatine kinase containing the B subunit. All patients with acute transmural infarcts had positive test results by both techniques, but concentrations of B-isoenzymes were more frequently above normal than were MB bands in the case of patients with acute subendocardial infarcts and in the case of all patients with acute myocardial infarcts from whom sera were collected more than 24 h after onset of chest pain. Concentrations of B-isoenzymes also were increased, even when MB bands were not electrophoretically detectable, in specimens from several patients without documented actue myocardial infarcts. These abnormal results presumably were caused by increased concentrations of the BB isoenzyme in serum. Accordingly, an increased concentration of B-isoenzymes had less diagnostic specificity and predictive value for acute myocardial infarction than did a detectable MB band. Results of isoenzyme electrophoresis were more reliable for establishing this diagnosis, but the results of radioimmunoassay were more reliable for excluding it in patients with chest pain as the primary symptom.

scholarly journals Primary care use and cardiovascular disease risk in Russian 40–69 year olds: a cross-sectional study

2020 ◽  
pp. jech-2019-213549
Author(s):  
Jakob Petersen ◽  
Anna Kontsevaya ◽  
Martin McKee ◽  
Erica Richardson ◽  
Sarah Cook ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Primary Care ◽  
Chest Pain ◽  
Russian Federation ◽  
General Health ◽  
Cross Sectional Study ◽  
Health Check ◽  
Sectional Study ◽  
Cvd Risk ◽  
Cross Sectional

BackgroundThe Russian Federation has very high cardiovascular disease (CVD) mortality rates compared with countries of similar economic development. This cross-sectional study compares the characteristics of CVD-free participants with and without recent primary care contact to ascertain their CVD risk and health status.MethodsA total of 2774 participants aged 40–69 years with no self-reported CVD history were selected from a population-based study conducted in Arkhangelsk and Novosibirsk, Russian Federation, 2015–2018. A range of co-variates related to socio-demographics, health and health behaviours were included. Recent primary care contact was defined as seeing primary care doctor in the past year or having attended a general health check under the 2013 Dispansarisation programme.ResultsThe proportion with no recent primary care contact was 32.3% (95% CI 29.7% to 35.0%) in males, 16.3% (95% CI 14.6% to 18.2%) in females, and 23.1% (95% CI 21.6% to 24.7%) overall. In gender-specific age-adjusted analyses, no recent contact was also associated with low education, smoking, very good to excellent self-rated health, no chest pain, CVD 10-year SCORE risk 5+%, absence of hypertension control, absence of hypertension awareness and absence of care-intensive conditions. Among those with no contact: 37% current smokers, 34% with 5+% 10-year CVD risk, 32% untreated hypertension, 20% non-anginal chest pain, 18% problem drinkers, 14% uncontrolled hypertension and 9% Grade 1–2 angina. The proportion without general health check attendance was 54.6%.ConclusionPrimary care and community interventions would be required to proactively reach sections of 40–69 year olds currently not in contact with primary care services to reduce their CVD risk through diagnosis, treatment, lifestyle recommendations and active follow-up.

scholarly journals Clinical value of chest pain presentation and prodromes on the assessment of cardiovascular disease: a cohort study

BMJ Open ◽  
2015 ◽  
Vol 5 (4) ◽  
pp. e007251-e007251 ◽  
Author(s):  
J. Robson ◽  
L. Ayerbe ◽  
R. Mathur ◽  
J. Addo ◽  
A. Wragg
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Chest Pain ◽  
Clinical Value

scholarly journals AYURVEDIC REVIEW ON DIAGNOSIS AND MANAGEMENT OF HRIDROGA WITH THE SPECIAL REFERENCE TO CARDIOVASCULAR DISEASE

AYUSHDHARA ◽  
2020 ◽  
pp. 2719-2724
Author(s):  
Deepti Sharma ◽  
Udai Raj Saroj ◽  
Abhishek Upadhyay ◽  
Binod Kumar Singh
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Chest Pain ◽  
Special Reference ◽  
Present Article ◽  
Modern Medicine ◽  
Diagnosis And Treatment ◽  
Diagnosis And Management ◽  
Excessive Intake ◽  
The Many

According to AcharyaSushruta, in the presence of the Etiological factors the dosha get vitiated and provoked all the three Doshas spread out of their place and vitiate the RasaDhatu in the heart. Vitiate Rasa Dhatu (body lymph /chyle) manifestation of various types of pain is being produced, which is called ‘Hridbadha’ or Hridroga. Cardiovascular disease (CVD) is the most important cause of global death, accounting for 17.3 million deaths per year, a number that is expected to grow to more than 23.6 million by 2030. Aim and objectives-Diagnosis and treatment of Hridroga through Ayurveda and its modern correlation.Mode ofAction of Hridyadrugs promoting heart’s health.Improper diet (excessive intake of Kshar, Lavana Rasa, Virudahbhojana) and Vegadharna, Chinta,Krodhaetc. are few among the many causes of Hridroga. In understanding symptomology of cardiovasculardisorder, it should be noted thatVaivarnya (Panduta /Shweta/Shyava) can be correlated to pallor and cyanosis, Murcchato Syncope, Kasato cough with or without Hemoptysis, Shwasato breathlessness or dyspnea, Ruja to Chest pain or discomfort. Drugs used in various formulations in Hridrogahaveproperties like Pachana, Deepana, Hridya, Anulomana,Rasayana and Krimihara.So, in present article an effort has been made to explain the heart disease and its management through Ayurveda as well as modern medicine.

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