Chest Pain

2018 ◽  
pp. 290-294
Author(s):  
Jennifer Bellis
Keyword(s):  
Chest Pain ◽  
Diagnostic Procedures ◽  
Diagnosis And Treatment ◽  
X Rays ◽  
Common Causes ◽  
Pediatric Chest

This chapter reviews the evaluation, workup, diagnosis and treatment of chest pain in a child. Additionally, it reviews common causes of pediatric chest pain as well as important components of the history and physical that may indicate a more serious cause of pediatric chest pain. These patients may require further diagnostic procedures or referral to a subspecialist for further evaluation. Finally, it discusses the role of electrocardiogram and chest X-rays in the workup of pediatric chest pain. In general, most adolescent occurrence of chest pain has a benign etiology, commonly with a musculoskeletal cause. Absent other abnormal findings, these patients often require only a minimal workup.

Neuromyelitis optica spectrum: novel concept of pathogenesis, diagnosis and treatment of Devic’s disease

2009 ◽  
Vol 150 (46) ◽  
pp. 2101-2109 ◽  
Author(s):  
Péter Csécsei ◽  
Anita Trauninger ◽  
Sámuel Komoly ◽  
Zsolt Illés
Keyword(s):  
Neuromyelitis Optica ◽  
Water Channel ◽  
Diagnostic Procedures ◽  
Diagnosis And Treatment ◽  
Clinical Settings ◽  
Permanent Disability ◽  
Therapeutic Decisions ◽  
Novel Concept ◽  
The Brain

The identification of autoantibodies generated against the brain isoform water channel aquaporin4 in the sera of patients, changed the current diagnostic guidelines and concept of neuromyelitis optica (NMO). In a number of cases, clinical manifestation is spatially limited to myelitis or relapsing optic neuritis creating a diverse. NMO spectrum. Since prevention of relapses provides the only possibility to reduce permanent disability, early diagnosis and treatment is mandatory. In the present study, we discuss the potential role of neuroimaging and laboratory tests in differentiating the NMO spectrum from other diseases, as well as the diagnostic procedures and therapeutic options. We also present clinical cases, to provide examples of different clinical settings, diagnostic procedures and therapeutic decisions.

scholarly journals The Role of Chest Radiography in Patients Presenting with Anterior Chest Pain to the Accident & Emergency Department

1988 ◽  
Vol 81 (11) ◽  
pp. 626-628 ◽  
Author(s):  
N J Russell ◽  
C F A Pantin ◽  
P A Emerson ◽  
N J Crichton
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Chest Radiography ◽  
False Negative ◽  
Junior Doctors ◽  
X Rays ◽  
Chest X Ray ◽  
Clinically Significant ◽  
Routine Chest

The chest radiological findings and outcomes of 120 consecutive patients attending the Accident & Emergency Department with anterior chest pain were recorded prospectively to investigate the value of routine chest radiography in their management. Twenty-one patients (17.5%) were excluded because of incomplete information. Thirty-seven radiological abnormalities were identified in 33 (33%) of the remaining 99 chest X-rays. Seventeen of the abnormalities identified in 14 (14%) of the chest X-rays were clinically significant. The casualty officer's interpretation of 70 (70%) of the chest X-rays was correct, but 36 errors were made interpreting the other 29 chest X-rays. Of these errors, 19 were false negative errors, resulting in the mismanagement of two patients and 17 false positive errors, resulting in the mismanagement of four patients. It appears that a routine chest X-ray provides little information of practical value in the management of patients with anterior chest pain attending an Accident & Emergency Department, unless the training of medical students and junior doctors in the interpretation of chest X-rays is improved.

scholarly journals Etiology and treatment of chest pain in children and adolescents

2020 ◽  
Vol 63 (7) ◽  
pp. 382-389
Author(s):  
Kyung Lim Yoon
Keyword(s):  
Chest Pain ◽  
Children And Adolescents ◽  
Cardiac Diseases ◽  
Common Symptom ◽  
Common Causes ◽  
Pediatric Chest ◽  
Life Threatening ◽  
Red Flag ◽  
Benign Nature ◽  
Complete History

Chest pain is a very common symptom in pediatric patients. Although children with chest pain are relatively unlikely to be suffering from significant cardiac diseases, it is important not to overlook life-threatening diseases. Complete history taking and physical examination––which involves identifying the duration of pain, onset, character, associated symptoms, and aggravating factors––are extremely important. The most common causes of pediatric chest pain are idiopathic and musculoskeletal, while less than 3% of cases are of cardiac origin. Recent studies indicate that chest pain resulted from psychosomatic disorders increases in non-cardiac chest pain in children and adolescents. The reassurance of the benign nature of chest pain is enough in most cases of non-cardiac chest pain in children and adolescents. When echocardiography is performed on patients with exertional chest pain, it is important to confirm the origin of coronary artery to exclude any coronary anomaly. Exertional chest pain, combined syncope, and symptoms of myocardial ischemia should raise the suspicion of significant cardiac diseases. When the chest pain is accompanied by red flag signs, physicians must refer the patients to a pediatric cardiologist.

scholarly journals The Close Relationship between Large Bowel and Heart: When a Colonic Perforation Mimics an Acute Myocardial Infarction

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Maria Francesca Secchi ◽  
Carlo Torre ◽  
Giovanni Dui ◽  
Francesco Virdis ◽  
Mauro Podda
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Conservative Treatment ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Diagnostic Procedures ◽  
Screening Colonoscopy ◽  
X Rays ◽  
Colonoscopic Perforation

Colonoscopic perforation is a serious and potentially life-threatening complication of colonoscopy. Its incidence varies in frequency from 0.016% to 0.21% for diagnostic procedures, but may be seen in up to 5% of therapeutic colonoscopies. In case of extraperitoneal perforation, atypical signs and symptoms may develop. The aim of this report is to raise the awareness on the likelihood of rare clinical features of colonoscopic perforation. A 72-year-old male patient with a past medical history of myocardial infarction presented to the emergency department four hours after a screening colonoscopy with polypectomy, complaining of neck pain, retrosternal oppressive chest pain, dyspnea, and rhinolalia. Right chest wall and cervical subcutaneous emphysema, pneumomediastinum, pneumoretroperitoneum, and bilateral subdiaphragmatic free air were reported on the chest and abdominal X-rays. The patient was treated conservatively, with absolute bowel rest, total parental nutrition, and broad-spectrum intravenous antibiotics. Awareness of the potentially unusual clinical manifestations of retroperitoneal perforation following colonoscopy is crucial for the correct diagnosis and prompt management of colonoscopic perforation. Conservative treatment may be appropriate in patients with a properly prepared bowel, hemodynamic stability, and no evidence of peritonitis. Surgical treatment should be considered when abdominal or chest pain worsens, and when a systemic inflammatory response arises during the conservative treatment period.

Pediatric Chest Pain: A Prospective Study

PEDIATRICS ◽  
1988 ◽  
Vol 82 (3) ◽  
pp. 319-323 ◽  
Author(s):  
Steven M. Selbst ◽  
Richard M. Ruddy ◽  
B. J. Clark ◽  
Frederick M. Henretig ◽  
Thomas Santulli
Keyword(s):  
Chest Pain ◽  
Age Groups ◽  
Acute Onset ◽  
Psychogenic Pain ◽  
Idiopathic Pain ◽  
Common Causes ◽  
Pediatric Chest ◽  
History Of ◽  
A Prospective Study ◽  
Ecg Abnormalities

Previous studies of childhood chest pain have been retrospective or considered only limited age groups or referred patients. In this study, all children who were admitted to the emergency department with chest pain were evaluated prospectively. Patients with ill-defined chest pain had ECGs and echocardiograms performed. A total of 407 children were evaluated. The most common causes of the pain were idiopathic (21%) and musculoskeletal (15%). Cardiac problems were found in 4%. Chest pain was acute (of <48 hours' duration) in 43% and chronic (of >6 months' duration) in 7%. Pain caused 30% of children to stay out of school and 31% to awaken from sleep. Chest wall tenderness was the most common abnormality. ECGs were obtained in 47%; results of 31/191 were abnormal but only 4/191 ECG abnormalities were related to the diagnosis. Echocardiograms were obtained in 34%; results of 17/139 were abnormal (12/139 showed mitral valve prolapse). Young children are more likely to have cardiorespiratory problems; children older than 12 years of age are more likely to have psychogenic pain. The description and location of the pain and the patient's sex are not related to the diagnosis. Nonorganic disease is related to a family history of heart disease or chest pain or having chronic pain. Organic disease is related to pain of acute onset, abnormal physical examination results, pain that awakens the child from sleep, and the presence of fever. Laboratory tests are rarely helpful in evaluating children with chest pain. Chest pain in children is usually benign. Psychogenic pain and idiopathic pain are less common than previously believed.

scholarly journals Role of Laparoscopy - A Diagnostic Aid, its Indications & Benefits

2016 ◽  
Vol 9 (3) ◽  
Author(s):  
Munir Saeed ◽  
Mahmood Ayyaz ◽  
Muhammad Arshad Cheema
Keyword(s):  
Abdominal Pain ◽  
Diagnostic Laparoscopy ◽  
Diagnostic Procedures ◽  
Chronic Abdominal Pain ◽  
Diagnosis And Treatment ◽  
Delay In Diagnosis ◽  
Abdominal Tumors ◽  
Open Laparotomy ◽  
Exploratory Procedure

Patients with an obscure and unrelievable abdominal condition may be forced to receive open laparotomy for diagnosis. Diagnostic Laparoscopy has been suggested as an alternative to diagnostic laparotomy in selected cases. It is a prospective descriptive study in which, thirty one patients under-going diagnostic Laparoscopy using conventional pneumoperitoneal techniques from January 2000 to June 2002 were included in this study. The correlation between preoperative diagnosis. laparoscopic diagnosis and pathologic diagnosis as well as the outcome of laparoscopic diagnosis and treatment have been assessed. Major indications for diagnostic Laparoscopy included acute abdominal pain (n=9). chronic abdominal pain (n=13), different intraabdominal tumor (n=7). All patients with acute abdominal conditions. 8 of the 13 patients with chronic abdominal pain and 4 of the 7 patients with abdominal tumors had no reasons for a further exploratory procedure, thus preventing the morbidity or mortality which might occur after unnecessary laparotomy. Diagnostic Laparoscopy benefits patients by avoiding unnecessary surgery. avoiding unnecessary delay in diagnosis and treatment and shortening the operative and hospitalized period. However. it provides only an alternative not a substitute for traditional diagnostic procedures and will never lessen the importance of conventional laparotomy.

scholarly journals Lung Ultrasound in Pediatrics and Neonatology: An Update

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1015
Author(s):  
Angela Ammirabile ◽  
Danilo Buonsenso ◽  
Antonio Di Mauro
Keyword(s):  
Potential Role ◽  
Lung Ultrasound ◽  
Pulmonary Diseases ◽  
X Rays ◽  
Pleural Surface ◽  
Therapeutic Decisions ◽  
Pediatric Chest ◽  
Ionizing Radiations ◽  
Respiratory Conditions

The potential role of ultrasound for the diagnosis of pulmonary diseases is a recent field of research, because, traditionally, lungs have been considered unsuitable for ultrasonography for the high presence of air and thoracic cage that prevent a clear evaluation of the organ. The peculiar anatomy of the pediatric chest favors the use of lung ultrasound (LUS) for the diagnosis of respiratory conditions through the interpretation of artefacts generated at the pleural surface, correlating them to disease-specific patterns. Recent studies demonstrate that LUS can be a valid alternative to chest X-rays for the diagnosis of pulmonary diseases, especially in children to avoid excessive exposure to ionizing radiations. This review focuses on the description of normal and abnormal findings during LUS of the most common pediatric pathologies. Current literature demonstrates usefulness of LUS that may become a fundamental tool for the whole spectrum of lung pathologies to guide both diagnostic and therapeutic decisions.

Digital x-ray mapping of nanometer-size supported bimetallic catalysts

1988 ◽  
Vol 46 ◽  
pp. 530-531
Author(s):  
L. T. Germinario
Keyword(s):  
Background Radiation ◽  
Metal Cluster ◽  
Single Element ◽  
Beam Diameter ◽  
X Rays ◽  
X Ray ◽  
Major Interest ◽  
Induced Changes

Understanding the role of metal cluster composition in determining catalytic selectivity and activity is of major interest in heterogeneous catalysis. The electron microscope is well established as a powerful tool for ultrastructural and compositional characterization of support and catalyst. Because the spatial resolution of x-ray microanalysis is defined by the smallest beam diameter into which the required number of electrons can be focused, the dedicated STEM with FEG is the instrument of choice. The main sources of errors in energy dispersive x-ray analysis (EDS) are: (1) beam-induced changes in specimen composition, (2) specimen drift, (3) instrumental factors which produce background radiation, and (4) basic statistical limitations which result in the detection of a finite number of x-ray photons. Digital beam techniques have been described for supported single-element metal clusters with spatial resolutions of about 10 nm. However, the detection of spurious characteristic x-rays away from catalyst particles produced images requiring several image processing steps.

1763: Stage Migration of upper Tract Transitional Cell Carcinoma: An Argument for the Continued Role of Endourologic Diagnosis and Treatment

2004 ◽  
Vol 171 (4S) ◽  
pp. 466-466
Author(s):  
Stephen A. Boorjian ◽  
Casey K. Ng ◽  
Ravi Munver ◽  
R. Ernest Sosa ◽  
E. Darracott Vaughan ◽  
...  
Keyword(s):  
Transitional Cell Carcinoma ◽  
Cell Carcinoma ◽  
Transitional Cell ◽  
Diagnosis And Treatment ◽  
Stage Migration ◽  
Upper Tract

Role of exosomes in diagnosis and therapy of prostate cancer

2020 ◽  
Vol 28 (3) ◽  
pp. 399-405
Author(s):  
Fabrizio Fontana ◽  
Olga A. Babenko
Keyword(s):  
Prostate Cancer ◽  
Cancer Cells ◽  
Tumor Cells ◽  
Biological Fluids ◽  
Diagnosis And Treatment ◽  
Diagnosis And Therapy ◽  
The Future ◽  
Important Direction ◽  
Potential Biomarkers

Aim of this letter is to attract the attention of journal readers to the study of exosomes as an important direction in the development of Oncology, in particular, in the diagnosis and treatment of prostate cancer. Exosomes are produced by tumor cells and regulate proliferation, metastasis, and the development of chemoresistance. Their extraction from biological fluids allows further use of these vesicles as potential biomarkers of prostate cancer. In the future, exosomes can be successfully used in the delivery of drugs and other anti-tumor substances to cancer cells.

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