The Yentl Syndrome: A Case Report

Cardiovascular disease, including ischemic heart disease, is one of the most common causes of death and disability in both sexes. The traditional concept of ischemic heart disease as a “man’s disease” is debunked. Yentl syndrome is used to describe the underdiagnosis of ischemic heart disease in females and its associated effects. This article reports a 48-year-old female presented to the emergency department with acute epigastric discomfort. Her initial diagnostic tests did not reveal any abnormalities, and she was discharged. Subsequently, after four days, she again visited the emergency department with chest pain, the evaluation of which furthermore revealed no abnormalities. However, we admitted her. After 40 hours of hospitalization, her evaluation revealed anterior wall ST elevation myocardial infarction, and she underwent emergent reperfusion via coronary catheterization. This combination of atypical signs and symptoms and chances of delayed manifestations in the diagnostic investigations provides evidence for a need for thorough assessment in a female with chest pain.

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Societal costs of non-cardiac chest pain compared with ischemic heart disease - a longitudinal study

BMC Health Services Research ◽

10.1186/1472-6963-13-403 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 27

Author(s):

Ghassan Mourad ◽

Jenny Alwin ◽

Anna Strömberg ◽

Tiny Jaarsma

Keyword(s):

Heart Disease ◽

Longitudinal Study ◽

Chest Pain ◽

Ischemic Heart Disease ◽

Ischemic Heart ◽

Societal Costs

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A study on the clinical profile and risk factors of ischemic heart disease in women

Medpusle International Journal of Medicine ◽

10.26611/102119310 ◽

2021 ◽

Vol 19 (3) ◽

pp. 130-132

Author(s):

Sarath Kumar Reddy B ◽

Keyword(s):

Risk Factors ◽

Heart Disease ◽

Chest Pain ◽

Ischemic Heart Disease ◽

Stable Angina ◽

Heart Diseases ◽

Chronic Stable Angina ◽

Clinical Profile ◽

Ischemic Heart ◽

Ischemic Heart Diseases

Background: Ischemic heart disease (IHD) is one of the principle causes of morbidity and of mortality in women1. Ischemic heart disease may manifest clinically as either chronic stable angina or acute coronary syndrome2 (ACS). Traditional risk factors (hypertension, diabetes, etc.) contribute to the development of IHD in both women and men. Some risk factors are unique to women (e.g., pregnancy-related complications, menopause), which cause increased mortality in women Aim: To study the risk factors and clinical profile of ischemic heart disease in women. Materials And Methods: Hospital-based prospective, cross-sectional study done in 50 patients with ischemic heart disease. Patients with a history of Chest pain suggestive of ischemic heart diseases and Electrocardiogram and cardiac biomarkers suggestive of ischemic heart disease were included in the study. Results: Maximum incidence of ischemic heart diseases is seen in the 6th decade. Mean age is 58.92 + 2.8years. 64%of the patients presented with chest pain, and 36% patients presented without any chest pain. After chest pain, the most common symptom was palpitations, seen in 56% patients, followed by sweating (44%). 30% presented to the medical facility within 3hours. 88% were diagnosed with acute coronary syndrome, and 12% were diagnosed with chronic stable angina. Women specific risk factors include the pregnancy-related complications seen in 10% patients, menopause attained in 86% patients, PCOS seen in 08% patients, use of oral contraceptive pills noticed in 08% patients, Other risk factors identified were hypothyroidism in 16% patients, connective tissue disorders like rheumatoid arthritis seen in 12% of the patients. Conclusion: Awareness regarding atypical symptoms as well as other symptoms of IHD should be created among women to avoid delayed complications. Simple lifestyle modifications like physical activity, diet modifications, etc., will reduce the number of women at risk for IHD.

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Abstract 14953: Temporal Trends in Non-invasive Diagnostic Tests for Ischemic Heart Disease Among Us Adults Age 64 Years or Younger: Results From the Marketscan Survey, 2010-2018

Circulation ◽

10.1161/circ.142.suppl_3.14953 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Soyoun Park ◽

Yuling Hong ◽

Cathleen Gillespie ◽

Robert Merritt ◽

Laurence Sperling

Keyword(s):

Heart Disease ◽

Chest Pain ◽

Ischemic Heart Disease ◽

Single Photon ◽

Adult Population ◽

Photon Emission ◽

Temporal Trends ◽

Ischemic Heart ◽

Non Invasive ◽

Exercise Ecg

Introduction: Heart disease is the leading cause of death in the U.S. Ischemic heart disease (IHD) accounts for two thirds of heart disease deaths. Non-invasive cardiovascular tests (NITs) are often the first step to establish an IHD diagnosis. Methods: We analyzed 2010-2018 IBM® MarketScan® Commercial Databases. NITs including exercise ECG, stress echocardiography, CT coronary artery calcification score (CT-CAC), single-photon emission computerized tomography (SPECT), cardiac CT angiography (CTA), nuclear positron emission tomography/myocardial perfusion imaging (PET/MPI), stress MRI, were identified using current procedural terminology (CPT) codes. IHD using ICD 9/10 codes (410-414, 429.2/I20-I25) and chest pain (786.59/R07.89) or unspecified chest pain (786.50/R07.9) were identified. The 2000 Census population was used to calculate the age standardized prevalence. Results: The data included 20,726,587 individuals (48.1% men, mean age (standard deviation) of 49.1 (13.5) years), among which 67,339 had a diagnosis of IHD or chest pain in 2018. The age standardized prevalence of the overall population that had at least one of the 7 tests is 1.60% in 2018, down from 2.47% in 2010. The responding prevalence for those with IHD or chest pain was 54.3% in 2018 and 61.6% in 2010. Exercise ECG was the most utilized test for the overall population: 0.94% in 2018 down from 1.31% in 2010; SPECT was second most often used with 0.75% in 2018 and 1.24% in 2010. However, SPECT was the most often utilized test among those with CHD or chest pain: 38.2% in 2018, down from 45.0% in 2010, and exercise ECG second most often with 32.6% in 2018 and 34.9% in 2010. An increase in use of CT-CAC, PET/MPI, and CTA tests was observed since 2010, but the prevalence of all were low in 2018. 0.02%. 0.01%, and 0.04% for the overall population and 0.20%, 0.95% and 3.20% for those with IHD or chest pain, respectively. Conclusions: Almost 2% of the general younger US adult population and over half of those with IHD or chest pain had undergone at least one of 7 NITs in 2018. While the utilization of overall NITs for both the general population and those with IHD or chest pain has declined since 2010, it has increased for CT-CAC, PET/MPI, and CTA but still less than 1% for CT-CAC and PET/MPI..

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PMD37 The Cost-Effectiveness Analysis of CT Coronary Angiography Versus Myocardial Spect for the Diagnosis of Ischemic Heart Disease in Patients with Chest Pain

Value in Health ◽

10.1016/j.jval.2012.03.377 ◽

2012 ◽

Vol 15 (4) ◽

pp. A68

Author(s):

S. Park ◽

H. Song ◽

H.J. Lee ◽

Y.J. Kim ◽

E.J. Jang ◽

...

Keyword(s):

Heart Disease ◽

Cost Effectiveness ◽

Chest Pain ◽

Coronary Angiography ◽

Ischemic Heart Disease ◽

Ct Coronary Angiography ◽

Ischemic Heart ◽

Myocardial Spect ◽

Effectiveness Analysis ◽

The Cost

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PAINLESS MYOCARDIAL INFARCTION;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.06.1778 ◽

2013 ◽

Vol 20 (06) ◽

pp. 882-886

Author(s):

IJAZ-UL-HAQUE TASEER ◽

SHAHZAD ALAM KHAN ◽

MUHAMMAD IMRAN NAZIR ◽

Sohail Safdar

Keyword(s):

Heart Disease ◽

Chest Pain ◽

Ischemic Heart Disease ◽

Health Care Professionals ◽

Research Work ◽

Sampling Technique ◽

Ischemic Heart ◽

Clinical Feature ◽

Suspected Case ◽

Coronary Syndrome

Objective: To determine the frequency of painless MI in patients with acute coronary syndrome. Study design: Descriptivecross-sectional study. Setting and duration: This study was conducted at cardiology unit Nishtar Hospital Multan and Chaudhry PervezElahi Institute of Cardiology Multan. The study duration was 1 year starting from July 2011 to June 2012. Materials and Methods: Thisdescriptive study included 331 patients of AMI of either sex and age which were admitted at “Cardiology unit Nishtar Hospital Multan andChaudhry Pervez Elahi Institute of Cardiology Multan” using non-probability convenience sampling technique. Informed verbal consentwas taken from each patient for participation. Results: Out of these 331 patients 308 (93.1%) patients reported chest pain as thepresenting complaint. Remaining 23(6.9%) presented with clinical feature other than chest pain. Of these 23 patients who presentedwithout chest, minimum age was 30 years while maximum was 90 years with mean age 54.82 ± 12.28 years. Patients with painless AMIpresented with variety of symptoms. Most common symptoms seen in patients of AMI without chest pain were generalized weakness andcold sweats. Out of 23 patients with painless AMI, 15(65.22%) patients were male and 08(34.8%) were female. Diabetes mellitus waspresent as co-morbid condition in 16(69.56%) while 7(30.44%) patients were non diabetic. Hypertension was present in 8(34.78%)patients with painless AMI. Conclusions: Painless AMI or atypical presentation of AMI is seen in substantial proportion of ischemic heartdisease patients. Absence of chest pain in AMI patients may misguide the doctors and diverts his attention towards other diagnosis whichcan lead to considerable delay in the essential therapies required in the management of AMI. It definitely affects morbidity and mortality ofemergency department. Health care professionals particularly those working in emergency set up must keep in mind that absence ofchest pain in suspected cases of ischemic heart disease does not necessarily rule out AMI. Features of AMI other than chest pain shouldalso be kept in mind while dealing with a suspected case of ischemic heart disease. Further research work on painless AMI andpresentation of AMI other than chest pain is needed.

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The role of platelet indices in ischemic heart disease: a hospital based case control type of study

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20193924 ◽

2019 ◽

Vol 7 (9) ◽

pp. 3426

Author(s):

Priyanka S. Gandhi ◽

Bhavna N. Gamit

Keyword(s):

Platelet Count ◽

Heart Disease ◽

Chest Pain ◽

Ischemic Heart Disease ◽

Heart Diseases ◽

Inverse Correlation ◽

Ischemic Heart ◽

Noncardiac Chest Pain ◽

Platelet Volume ◽

Pain Patients

Background: In developing countries, Ischemic heart diseases (IHD) is one of the leading causes of morbidity and mortality. The underlying pathology of CAD is atherosclerosis. When this atherosclerotic plaque ruptures, platelets play a crucial role in the prothrombotic events and forms a thrombus on this plaque and as a result coronary artery gets occluded causing ischemia and infarction. Platelet contains many chemokines, cytokines and growth factors. Release of these factors along with interaction with endothelial cells and leukocytes promotes inflammation and progression of atherosclerosis. We aimed to investigate the association between platelet volume indices in patients with diagnosis of Ischemic heart disease in comparison with control group.Methods: By using automated cell counter platelet count and platelet volume indices - were compared with Normal healthy or non-cardiac chest pain patients with the use of unpaired t test.Results: In the present study, we demonstrated that platelet count is significantly low and MPV and PDW are significantly high in Ischemic heart disease as compared to patients with noncardiac chest pain or healthy subjects. The correlation of MPV with PC revealed an inverse correlation between the patients of IHD and healthy or non-cardiac chest pain patients which is statistically significant.Conclusions: The platelet volume indices are an important, simple, effortless and a cost-effective tool useful in predicting the development of an acute coronary event sometimes in the near future and therapeutic modification for improved patient’s cardiovascular care.

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