Chest Pain, ST Elevation, and Positive Cardiac Enzymes in an Austere Environment: Differentiating Smallpox Vaccination-mediated Myocarditis and Acute Coronary Syndrome in Operation Iraqi Freedom

2012 ◽  
Vol 42 (3) ◽  
pp. 267-270 ◽  
Author(s):  
Charles L. Taylor ◽  
Robert E. Eckart
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Operation Iraqi Freedom ◽  
Smallpox Vaccination ◽  
Cardiac Enzymes ◽  
Coronary Syndrome ◽  
Austere Environment ◽  
St Elevation ◽  
Iraqi Freedom

scholarly journals Fitting a Square Peg in a Round Hole: A Simple Case of Chest Pain

2020 ◽  
Vol 4 (1) ◽  
pp. 1-7
Author(s):  
Mary McLean ◽  
Jennifer Beck-Esmay
Keyword(s):  
Risk Factors ◽  
Chest Pain ◽  
Young Women ◽  
Point Of Care ◽  
Round Hole ◽  
Shortness Of Breath ◽  
Cardiac Enzymes ◽  
Coronary Syndrome ◽  
St Elevation ◽  
Atherosclerotic Risk Factors

A 39-year-old female presents to the emergency department with chest pain and shortness of breath. Her electrocardiogram suggests ST-elevation myocardial infarction, but she has no atherosclerotic risk factors. She is gravida 4, para 4, and four weeks postpartum from uncomplicated vaginal delivery. She is diaphoretic and anxious, but otherwise her exam is unremarkable. Cardiac enzymes are markedly elevated and point-of-care echocardiogram shows inferolateral hypokinesis and ejection fraction of 50%. In this clinicopathological case, we explore a classically underappreciated cause of acute coronary syndrome in healthy young women.

Chest Pain and Acute Coronary Syndrome (DRAFT)

2018 ◽  
Author(s):  
Stephen D’Auria ◽  
Ravi Ramani
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Rapid Response Team ◽  
St Elevation Myocardial Infarction ◽  
Coronary Syndrome ◽  
Methodical Approach ◽  
Response Team ◽  
St Elevation ◽  
A Minor

Chest pain is a common presenting complaint faced by the rapid response team (RRT), and can herald a serious process such as acute coronary syndrome or aortic dissection, or be secondary to a minor muscle strain. A methodical approach to chest pain is necessary to avoid premature diagnostic closure. One of the most feared diagnoses is a myocardial infarction. Fortunately, there are well-established guidelines describing the necessary steps for treatment of both ST elevation myocardial infarction (STEMI) and non-ST elevation myocardial infarction (NSTEMI). This chapter will address the differential for chest pain as well as established guidelines for treatment of acute coronary syndrome.

scholarly journals Cardiac headache in acute coronary syndrome

2017 ◽  
Vol 4 (3) ◽  
pp. 21
Author(s):  
Phillip Tran ◽  
Robert Ziffra ◽  
Hoai V. Nguyen ◽  
Selena M. Losee
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Wide Distribution ◽  
Severe Headache ◽  
Coronary Risk Factors ◽  
Coronary Risk ◽  
Coronary Syndrome ◽  
St Elevation

Acute coronary syndrome may present in a wide distribution of symptoms. The classic presentation includes substernal chest pain, neck pain, dyspnea or syncope. In patients with coronary risk factors who present with headaches, acute coronary syndrome is rare, but has been previously reported. We describe a case of 63-year-old female who presented with a severe headache and developed a Non ST Elevation Myocardial Infarction.

Is Telemetry Monitoring Useful in Patients Admitted With Suspected Acute Coronary Syndrome?

2017 ◽  
Vol 32 (6) ◽  
pp. 638-643
Author(s):  
Jack Perkins ◽  
Naveen K. Voore ◽  
Jaideep Patel ◽  
Sathish Sanna ◽  
Edana Mann ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Medical Records ◽  
Chief Complaint ◽  
Younger Patients ◽  
Coronary Syndrome ◽  
History Of ◽  
St Elevation ◽  
Artery Disease ◽  
Study Participants

Patients with a chief complaint of chest pain are frequently monitored by telemetry for evaluation of acute coronary syndrome (ACS). However, there is insufficient evidence to support this practice in younger patients without coronary artery disease (CAD). The objective is to assess outcomes of patients younger than 50 years of age and monitored by telemetry. Consecutive medical records of patients admitted for chest pain between January 1, 2009, and June 30, 2010, were reviewed. Patients were excluded who had a CAD history, an abnormal initial troponin, or an abnormal initial electrocardiogram. The remaining patients’ charts were evaluated for adverse events such as death, dysrhythmias, ST-elevation myocardial infarction, or upgrade to a higher level of care. Ultimately, 814 patients were selected for study. No study participants suffered a significant adverse event. When being evaluated for ACS, patients younger than 50 without a history of CAD may not benefit from telemetry monitoring.

scholarly journals Association of mean platelet volume and acute coronary syndrome

2017 ◽  
Vol 5 (4) ◽  
pp. 1217 ◽  
Author(s):  
Hasim Ahamed ◽  
Renoy A. Henry ◽  
Rema Pai
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Mean Platelet Volume ◽  
Coronary Thrombosis ◽  
Platelet Volume ◽  
Coronary Syndrome ◽  
Vessel Disease ◽  
Significant Difference ◽  
St Elevation ◽  
The Mean

Background: Acute coronary syndrome (ACS) is a set of signs and symptoms due to rupture of a plaque and are a consequence of platelet rich coronary thrombus formation. Larger platelets are haemostatically more active and and hence carry risk for developing coronary thrombosis leading to ACS. Platelet parameters especially mean platelet volume (MPV) could be used as an important and reliable marker in early detection of ACS when the patients come to emergency department with chest pain. The primary objective is to study the association between mean platelet volume and acute coronary syndrome. The secondary objectives are to analyse if there is a statistically significant difference in mean platelet volume between Non-ST elevation (NSTEMI) and ST-elevation Myocardial Infarction (STEMI) and between double vessel disease (DVD) and triple vessel disease (TVD).Methods: A total of 260 patients were included in the study depending on the inclusion and exclusion criteria. After dividing the patients with chest pain into control (Non-cardiac chest pain) and study group (ACS) which contained 130 each, venous blood was drawn and taken to haematology laboratory for analysis of MPV within 2 hrs. The statistical analysis used were mean, median, test of significance in difference (t-test) and chi-square test.Results: Mean platelet volume (MPV) was found to be higher among ACS patients (9.4868±0.85270) as compared to control (7.430±0.72172) and it was significant with a P value <0.05. It was also noticed that MPV was higher among patients with STEMI when compared to NSTEMI, 10.32±0.77932 and 9.22±0.52743 and it was statistically significant (P<0.05). Similarly, MPV between patients with triple and double vessel disease were compared and the mean MPV of 10.04±0.88738 of TVD was greater than the mean MPV of 9.22±0.67438 in DVD and was statistically significant (P<0.05).Conclusions: In this study the MPV was higher in patients with ACS than those in control group. The study also showed that there was significant difference in MPV values between people with STEMI and NSTEMI and between people with DVD and TVD. Hence it might be useful as an additional cost efficient test in conjunction with other markers in the early prediction of ACS in the emergency room. Larger platelets are haemostatically more active and hence carry risk for developing coronary thrombosis leading to ACS. Patients with increased MPV could be easily identified during routine haematological analysis and hence could play an important role in early detection of acute coronary syndrome (ACS).

scholarly journals A mimic of a STEMI in an elderly male patient at emergency department requiring no stent

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Lagath Wanigabadu ◽  
◽  
Jithesh Choyi ◽  
Shahram Ahmadvazi ◽  
Sarah Justice ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Coronary Angiography ◽  
Male Patient ◽  
Apical Ballooning ◽  
Elderly Male ◽  
Coronary Syndrome ◽  
St Elevation

An elderly male patient presented with chest pain and an initially abnormal ECG, with 1 mm ST elevation in the lateral leads. As he was pain free on arrival, he was treated locally, where a coronary angiography showed no stenosis and echocardiography showed apical ballooning which indicated Takotsubo Cardiomyopathy (TC). On further questioning, he indicated he has been worrying about his son’s financial circumstances. Patients with TC can present with a history and an ECG resembling and indistinguishable from ST-elevation Myocardial infarction or other types of Acute Coronary Syndrome (ACS).

scholarly journals Chest Pain in Adolescent Japanese Male Mimicking Acute Coronary Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Sachin K. Gupta ◽  
Zahra Naheed
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Adult Population ◽  
Acute Chest Pain ◽  
Adolescent Male ◽  
Cardiac Enzymes ◽  
Coronary Syndrome ◽  
Adolescent Population ◽  
Japanese Male ◽  
Enzyme Elevation

Acute chest pain with very elevated troponin level and abnormal EKG in adult population is considered sine qua non to acute coronary syndrome (ACS) unless proved otherwise. Similar presentation in adolescent population is seen less often but raises suspicion for ACS. Most common etiology for chest pain with cardiac enzyme elevation in adolescent population is usually viral myopericarditis. The adolescent population presenting with chest pain and elevated cardiac enzymes should be carefully evaluated for ACS and other etiologies including myocarditis, myopericarditis, pulmonary embolism, acute rheumatic fever, and trauma. We report one Japanese adolescent male with mycoplasma pneumoniae myocarditis who presented to the ER with chest pain, elevated cardiac enzymes, and abnormal EKG.

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