scholarly journals External Validation of the No Objective Testing Rules in Acute Chest Pain

2021 ◽  
Author(s):  
Paul David Ratmann ◽  
Jasper Boeddinghaus ◽  
Thomas Nestelberger ◽  
Pedro Lopez‐Ayala ◽  
Luca Koechlin ◽  
...  
Keyword(s):  
Chest Pain ◽  
External Validation ◽  
Acute Chest Pain ◽  
Objective Testing

Plasma Fibrinopeptide A and Beta-Thromboglobulin in Patients with Chest Pain

1983 ◽  
Vol 50 (02) ◽  
pp. 541-542 ◽  
Author(s):  
J T Douglas ◽  
G D O Lowe ◽  
C D Forbes ◽  
C R M Prentice
Keyword(s):  
Myocardial Infarction ◽  
Chest Pain ◽  
Unstable Angina ◽  
Plasma Levels ◽  
Thrombin Generation ◽  
Acute Chest Pain ◽  
Fibrinopeptide A ◽  
Control Hospital ◽  
Hospital Patients ◽  
Platelet Release

SummaryPlasma levels of β-thromboglobulin (BTG) and fibrinopeptide A (FPA), markers of platelet release and thrombin generation respectively, were measured in 48 patients within 3 days of admission to hospital for acute chest pain. Twenty-one patients had a confirmed myocardial infarction (MI); 15 had unstable angina without infarction; and 12 had chest pain due to noncardiac causes. FPA and BTG were also measured in 23 control hospital patients of similar age. Mean plasma BTG levels were not significantly different in the 4 groups. Mean plasma FPA levels were significantly higher in all 3 groups with acute chest pain when compared to the control subjects (p < 0.01), but there were no significant differences between the 3 groups. Increased FPA levels in patients with acute chest pain are not specific for myocardial infarction, nor for ischaemic chest pain.

Investigating Decrease in Radiation Dose using Acute Chest Pain Coronary CT with 128 slice MDCT Scanner

2018 ◽  
Vol 20 (1) ◽  
pp. 23-32
Author(s):  
Yong-Seob Kim ◽  
◽  
Cheon-Ung Park ◽  
Eun-Jung Kim ◽  
Sook-Hee Lee ◽  
...  
Keyword(s):  
Chest Pain ◽  
Radiation Dose ◽  
Acute Chest Pain ◽  
Coronary Ct ◽  
Mdct Scanner

Virus causes acute chest pain

1986 ◽  
Vol 144 (5) ◽  
pp. 278-279
Author(s):  
C.R. Boughton
Keyword(s):  
Chest Pain ◽  
Acute Chest Pain

Virus causes acute chest pain

1986 ◽  
Vol 144 (5) ◽  
pp. 278-278 ◽  
Author(s):  
Garnet Simpson
Keyword(s):  
Chest Pain ◽  
Acute Chest Pain

scholarly journals Impact of more conservative European Society of Cardiology guidelines on the management of patients with acute chest pain

2021 ◽  
Author(s):  
Calvin L. Kienbacher ◽  
Verena Fuhrmann ◽  
Raphael Tulder ◽  
Christof Havel ◽  
Wolfgang Schreiber ◽  
...  
Keyword(s):  
Chest Pain ◽  
European Society ◽  
Acute Chest Pain ◽  
European Society Of Cardiology

scholarly journals Adding stress biomarkers to high sensitivity troponin measurements increases precision and efficacy of rapid rule out protocols for NSTEMI

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
I Restan ◽  
O.T Steiro ◽  
H.L Tjora ◽  
J Langoergen ◽  
T Omland ◽  
...  
Keyword(s):  
Chest Pain ◽  
Acute Chest Pain ◽  
High Sensitivity ◽  
Final Diagnosis ◽  
Public Institution ◽  
P Value ◽  
Funding Source ◽  
University Hospitals ◽  
High Sensitivity Troponin ◽  
Rule Out

Abstract Background NSTEMI may be ruled out in patients presenting with acute chest pain based on low baseline high sensitivity troponin (cTn) at admission. This procedure is limited by a low expected frequency of ruled out non-cardiac chest pain (NCCP) patients. Purpose To investigate if stress-induced biomarkers (glucose or copeptin) combined with cTn can increase the rate of NCCP ruled out without an unacceptable increase in incorrectly ruled out NSTEMI. Method 971 patients with suspected NSTE-ACS were included. Final diagnosis was adjudicated by two independent cardiologists using clinical data including routine cTnT. Additionally, baseline cTnI, cTnI from Singulex Clarity System (cTnI(sgx)), copeptin and glucose were measured. Diagnostic performance to rule out NSTEMI was compared between the ESC rule out algorithms for cTnT and cTnI(Abbott), a local cTnI(sgx) algorithm and different combinations of cTn with copeptin or glucose Results Median age 61 years, 60% male. 13% had NSTEMI, 12% had UAP and 60% NCCP. Distribution of copeptin and glucose concentrations (NSTEMI and NCCP) is shown in figure 1. Copeptin and cTnT produces an algorithm with lower miss rate for NSTEMI, increased rule out rate for NCCP and significantly higher AUC (DeLong test, p value &lt;0.001) compared to the ESC algorithm (Table 1). cTnI(sgx) and copeptin showed higher rule out for NCCP and higher AUC (p value &lt;0.001), however an increased rule out rate for NSTEMIs. Combining cTnI(Abbott) and glucose gave a similar miss rate for NSTEMI as ESC, but increased rule out rate for NCCP and higher AUC (p value &lt;0.001). Conclusion Combining cTnT or cTnI(sgx) with copeptin; or cTnI with glucose, improves diagnostic precision and efficacy of rule out protocols for NSTEMI in patients presenting with acute chest pain. Figure 1 Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Western Norway Regional Health Authority; Haukeland and Stavanger University Hospitals

scholarly journals The triple rule out CT in acute chest pain: a challenge for emergency radiologists?

2021 ◽  
Author(s):  
Vincenzo Russo ◽  
Camilla Sportoletti ◽  
Giulia Scalas ◽  
Domenico Attinà ◽  
Francesco Buia ◽  
...  
Keyword(s):  
Chest Pain ◽  
Emergency Radiology ◽  
Acute Chest Pain ◽  
Radiology Workflow ◽  
Radiology Department ◽  
Atypical Chest Pain ◽  
Triple Rule Out ◽  
Good Diagnostic Accuracy ◽  
Rule Out ◽  
Ct Studies

Abstract Purpose To evaluate the feasibility of triple rule out computed tomography (TRO-CT) in an emergency radiology workflow by comparing the diagnostic performance of cardiovascular and general radiologists in the interpretation of emergency TRO-CT studies in patients with acute and atypical chest pain. Methods Between July 2017 and December 2019, 350 adult patients underwent TRO-CT studies for the assessment of atypical chest pain. Three radiologists with different fields and years of expertise (a cardioradiologist—CR, an emergency senior radiologist—SER, and an emergency junior radiologist—JER) retrospectively and independently reviewed all TRO-CT studies, by trans-axial and multiplanar reconstruction only. Concordance rates were then calculated using as reference blinded results from a different senior cardioradiologist, who previously evaluated studies using all available analysis software. Results Concordance rate was 100% for acute aortic syndrome (AAS) and pulmonary embolism (PE). About coronary stenosis (CS) for non-obstructive (<50%), CS concordance rates were 97.98%, 90.91%, and 97.18%, respectively, for CR, SER, and JER; for obstructive CS (>50%), concordance rates were respectively 88%, 85.7%, and 71.43%. Moreover, it was globally observed a better performance in the evaluation of last half of examinations compared with the first one. Conclusions Our study confirm the feasibility of the TRO-CT even in an Emergency Radiology department that cannot rely on a 24/7 availability of a dedicated skilled cardiovascular radiologist. The “undedicated” radiologists could exclude with good diagnostic accuracy the presence of obstructive stenosis, those with a clinical impact on patient management, without needing time-consuming software and/or reconstructions.

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