scholarly journals The Causes of Chest Pain in Children and the Criteria for Targeted Myocardial Enzyme Testing in Identifying the Causes of Chest Pain in Children

2021 ◽  
Vol 8 ◽  
Author(s):  
Li Chen ◽  
Hongzhou Duan ◽  
Xiaoyan Li ◽  
Zuozhen Yang ◽  
Meng Jiao ◽  
...  
Keyword(s):  
Chest Pain ◽  
Physical Examination ◽  
Resource Use ◽  
Diagnostic Procedure ◽  
Pediatric Cardiology ◽  
Diagnostic Procedures ◽  
Chest Tightness ◽  
Adolescent Group ◽  
Common Complaint ◽  
Cardiac Evaluation

Aims: Chest pain is a common complaint at pediatric cardiology clinics and often leads to an extensive cardiac evaluation. In this study, we analyzed the causes of chest pain in Chinese children and developed diagnostic procedures and criteria for targeted myocardial enzyme testing.Methods and Results: We retrospectively analyzed the clinical data of patients aged below 18 years visiting our hospital for chest pain between 2005 and 2019. Based on auxiliary exams and clinical diagnosis, we developed diagnostic procedures and criteria for targeted myocardial enzyme testing in children with chest pain. A total of 7,251 children were included in this study. The chest pain was of cardiac origin in 581 patients (8.0%). The incidence of non-cardiac chest pain was significantly higher in the preschool group and the school-age group than in the adolescent group (93.5 vs. 93.8 vs. 90.3%, P < 0.05). Among children with cardiac chest pain, the most common concomitant symptom was chest tightness (67.0%). Myocardial enzyme testing was performed in 5,408 patients and was abnormal in 453 patients. We developed a diagnostic procedure and criteria for targeted myocardial enzyme testing using pertinent history, physical examination, and ECG findings or UCG finding. Applying the diagnostic procedure and criteria could lead to the reduction in myocardial enzyme testing while still capturing all cardiac diagnoses.Conclusion: In children, chest pain is mostly benign and rarely cardiac. During diagnosis, targeted myocardial enzyme testing based on medical history and physical examination can effectively reduce resource use.

scholarly journals The Causes of Chest Pain and the Positive Rate of Myocardial Enzyme Testing in Diagnosis of Chest Pain in Children

2021 ◽  
Author(s):  
Li Chen ◽  
Hongzhou Duan ◽  
Xiaoyan Li ◽  
Zuozhen Yang ◽  
Meng Jiao ◽  
...  
Keyword(s):  
Chest Pain ◽  
Resource Use ◽  
Pediatric Cardiology ◽  
Noncardiac Chest Pain ◽  
Age Group ◽  
Chest Tightness ◽  
Adolescent Group ◽  
Common Complaint ◽  
Positive Rate ◽  
Cardiac Evaluation

Abstract Background Chest pain is a common complaint at pediatric cardiology clinics and often leads to an extensive cardiac evaluation. In this study, we analyzed the causes of chest pain in Chinese children and developed criteria for targeted myocardial enzyme testing.Methods We retrospectively analyzed the clinical data of patients aged below 18 years visiting our hospital for chest pain between 2005 and 2019. Based on auxiliary exams and clinical diagnosis, we analyzed the positive rate of myocardial enzyme testing in identifying the causes of chest pain in children.Results A total of 7251 children were included in this study. The chest pain was of cardiac origin in 581 patients (8.0%). The incidence of noncardiac chest pain was significantly higher in the preschool group and the school-age group than in the adolescent group (93.5% vs 93.8% vs 90.3%, P < 0.05). Among children with cardiac chest pain, the most common concomitant symptom was chest tightness (67.0%). Myocardial enzyme testing was performed in 5408 patients and was abnormal in 453 (8.4%) patients.Conclusions In children, chest pain is mostly benign and rarely cardiac. During diagnosis, targeted myocardial enzyme testing based on medical history and physical examination can effectively reduce resource use.

scholarly journals A 15-Year-Old Boy with Anterior Chest Pain, Progressive Dyspnea, and Subcutaneous Emphysema of the Neck

2009 ◽  
Vol 2009 ◽  
pp. 1-3
Author(s):  
Nicola Scichilone ◽  
Maria Buttacavoli ◽  
Gaetana Camarda ◽  
Margherita Marchese ◽  
Maria Bellia ◽  
...  
Keyword(s):  
Chest Pain ◽  
Subcutaneous Emphysema ◽  
Respiratory Diseases ◽  
Skin Prick Testing ◽  
Diagnostic Procedures ◽  
Chest Tightness ◽  
Nasal Blockage ◽  
Progressive Dyspnea ◽  
Windy Weather

We describe the case of an adolescent who was admitted to the hospital because of sudden occurrence of chest pain, dyspnea and subcutaneous emphysema. On admission, physical examination revealed subcutaneous crepitations in the superior part of the rib cage, and auscultation of the chest showed widespread wheezing. The radiological assessment confirmed the diagnosis of pneumomediastinum and pneumothorax. A follow-up CT scan performed one week after the admission showed almost complete resolution of the radiological alterations. At the following visits, the patient was asymptomatic, but reported to have suffered from frequent episodes of rhinorrea, sneezing, nasal blockage, and sometimes, chest tightness, especially during exposure to pets and/or windy weather. Skin prick testing showed sensitivities to dermatophagoides pteronyssinus and farinae, grass pollen and dog dander. Spirometry documented significant improvement in lung function after short-acting bronchodilator, allowing for the diagnosis of asthma to be made. Although pneumomediastinum may be a complication of various respiratory diseases, including asthma, it has never been reported as the first presentation of underlying bronchial asthma. Herein, the physiopathological mechanisms, the diagnostic procedures and treatment of pneumomediastinum in asthma are discussed. We suggest that the diagnosis of asthma should be considered in the differential diagnosis of pneumomediastinum in adolescence.

scholarly journals The role of intravenous cholangio-cholecystography in assessment of asymptomatic choledocholithiasis

2003 ◽  
Vol 56 (3-4) ◽  
pp. 178-182
Author(s):  
Dragos Stojanovic ◽  
Mirjana Stojanovic ◽  
Zorica Caparevic ◽  
Djordje Lalosevic ◽  
Gradimir Bojkovic ◽  
...  
Keyword(s):  
Physical Examination ◽  
Biliary Tract ◽  
Diagnostic Procedure ◽  
Surgical Intervention ◽  
Diagnostic Procedures ◽  
Anatomic Variations ◽  
Diagnostic Protocol ◽  
Diagnostic Models ◽  
Therapeutic Problem

Introduction Standard diagnostic procedures (anamnesis, physical examination, laboratory analyses, ultrasound diagnosis), commonly used in diagnosis and preparation for surgical intervention of patients with cholelithiasis, are in most cases a reliable indicator for evaluation of the disease and conditions planned for surgery. Discussion In some cases by application of these narrow diagnostic models, some conditions, anatomic variations and biliary tract malformations remain unrecognized. Asymptomatic ('silent') choledocholithiasis (2.02%) represents a special diagnostic and therapeutic problem. Conclusion Our extended diagnostic protocol includes routine intravenous cholangio-cholecystography as a standard diagnostic procedure for evaluation of cholecysto-choledocholithiasis prior planning cholecystectomy.

Evaluation of Chest Pain in Children

1986 ◽  
Vol 8 (2) ◽  
pp. 56-62
Author(s):  
Steven M. Selbst
Keyword(s):  
Chest Pain ◽  
Physical Examination ◽  
Laboratory Tests ◽  
Good Prognosis ◽  
Detailed History ◽  
Common Complaint ◽  
Complete Physical Examination

Childhood chest pain is a common complaint and often a recurrent, chronic symptom. A detailed history and complete physical examination are the most important aspects of evaluating a child with chest pain. Childhood chest pain has a good prognosis. Laboratory tests should only be ordered if they are indicated on the basis of history and physical examination findings.

scholarly journals Isolated Left Ventricular Noncompaction in a Case of Sotos Syndrome: A Casual or Causal Link?

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Patrizia Saccucci ◽  
Federica Papetti ◽  
Roberta Martinoli ◽  
Alessandro Dofcaci ◽  
Ursula Tuderti ◽  
...  
Keyword(s):  
Physical Examination ◽  
Causal Link ◽  
Left Ventricular ◽  
Wall Thickening ◽  
Ventricular Wall ◽  
Sotos Syndrome ◽  
Left Ventricular Noncompaction ◽  
Ventricular Noncompaction ◽  
Cardiac Evaluation ◽  
Chromosome 5Q35

A 16-year-old boy affected by Sotos syndrome was referred to our clinic for cardiac evaluation in order to play noncompetitive sport. Physical examination was negative for major cardiac abnormalities and rest electrocardiogram detected only minor repolarization anomalies. Transthoracic echocardiography showed left ventricular wall thickening and apical trabeculations with deep intertrabecular recesses, fulfilling criteria for isolated left ventricular noncompaction (ILVNC). Some sporadic forms of ILVNC are reported to be caused by a mutation on CSX gene, mapping on chromosome 5q35. To our knowledge, this is the first report of a patient affected simultaneously by Sotos syndrome and ILVNC.

scholarly journals Development of quality metrics for ambulatory pediatric cardiology: Chest pain

2017 ◽  
Vol 12 (6) ◽  
pp. 751-755 ◽  
Author(s):  
Jimmy C. Lu ◽  
Manish Bansal ◽  
Sarina K. Behera ◽  
Jeffrey R. Boris ◽  
Brian Cardis ◽  
...  
Keyword(s):  
Chest Pain ◽  
Pediatric Cardiology ◽  
Quality Metrics

Handbook of Cardiology, by L. Jerome Krovetz, M.D., Ph.D., and Gerold L. Schiebler, M.D., with a foreword by Richard T. Smith, M.D. New York/Evanston, London: Hoeber Medical Division, Harper and Row, 1969, 388 pp., $16.50

PEDIATRICS ◽  
1970 ◽  
Vol 45 (2) ◽  
pp. 358-358
Author(s):  
Gladys J. Fashena
Keyword(s):  
New York ◽  
Physical Examination ◽  
Pediatric Cardiology ◽  
Common Disease ◽  
Experimental Production ◽  
Laboratory Examination ◽  
Cardiac Anomalies ◽  
Medical Division ◽  
Disease Entities

This concise, highly readable compendium grew out of an optimistic attempt by the authors, some years ago, to cover the field of pediatric cardiology in a 2-day lecture seminar! The general aim is to offer a brief basic introduction to pediatric cardiology, with emphasis on fundamental general considerations as well as the more common disease entities. The first 11 chapters deal with the basic tools of pediatric cardiology such as anatomy and embryology, experimental production and genetics of cardiac anomalies, abnormal hemodynamics, the physical examination, and the various modalities of laboratory examination.

CHEST PAIN AND DEPRESSION

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 575-575
Author(s):  
R. J. Haggerty
Keyword(s):  
Major Depressive Disorder ◽  
Differential Diagnosis ◽  
Chest Pain ◽  
Depressive Disorder ◽  
Children And Adolescents ◽  
Pediatric Cardiology ◽  
Cardiovascular Disorders ◽  
Major Depressive ◽  
Cardiology Department ◽  
Depressed Group

The study reports on 100 children and adolescents evaluated in a pediatric cardiology department. The results state that 13% of the population met the criteria for Major Depressive Disorder based on DSM III. There were four patients who were referred because of chest pain. All of them were found to be free from cardiovascular disorders, but all were found to be in the depressed group. The authors emphasize the importance of chest pain in differential diagnosis of childhood depression.

scholarly journals Medulloblastoma Presenting as Severe Headache during Pregnancy: A Case Report and Review of the Literature

Medicina ◽  
2022 ◽  
Vol 58 (1) ◽  
pp. 127
Author(s):  
Francesca Gabriela Paslaru ◽  
Anca Maria Panaitescu ◽  
Elena Nestian ◽  
George Iancu ◽  
Alina Veduta ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Imaging Techniques ◽  
Diagnostic Procedures ◽  
Intracranial Tumor ◽  
Neurological Deficits ◽  
Physiological Changes ◽  
Intracranial Tumors ◽  
Review Of The Literature ◽  
Common Complaint ◽  
Persistent Headache

Headache is a common complaint during pregnancy and the puerperium. The differentiation between a benign headache and a headache that has an underlying more endangering cause, such as an intracranial tumor, can be difficult and often requires diagnostic procedures and brain imaging techniques. We report the case of an 18-year-old female patient who developed clinical symptoms—persistent headache followed by neurological deficit—in the last part of her pregnancy. A medulloblastoma (MB) was diagnosed and treated after delivery. We review 11 other cases of MB in pregnancy reported in the literature. The most common clinical manifestation at diagnosis was headache followed by neurological deficits. We discuss the association of brain tumor growth with physiological changes during pregnancy. We conclude that clinical features of intracranial tumors can be misinterpreted as pregnancy-related symptoms and should not be dismissed.

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