scholarly journals Chest pain and an abnormal chest X-ray – a case report

2013 ◽  
Vol 12 (4) ◽  
pp. 227-229
Author(s):  
Nicholas Smallwood ◽  
◽  
Sarah Perrio ◽  
Keyword(s):  
Chest Pain ◽  
Common Symptom ◽  
C Reactive Protein ◽  
Diagnostic Challenge ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Acute Medical Unit ◽  
Abnormal Chest ◽  
Chest X Ray ◽  
Early Surgical Intervention

Chest pain is a common symptom amongst patients presenting to the acute medical unit, and presents a diagnostic challenge. We present the case of a previously healthy 65 year old year old gentleman with chest pain and subsequent vomiting, treated initially as an acute coronary syndrome, despite normal ECG and troponin. Chest radiograph revealed left basal consolidation with an effusion, suggesting pneumonia. The absence of symptoms of respiratory infection along with a normal C-reactive protein level led to further investigation with CT. This revealed evidence of oesophageal rupture (Boerhaave’s syndrome). Despite early surgical intervention our patient suffered a number of complications and continues his recovery in hospital three months post presentation.

High and low dose atorvastatin effects on high sensivity C-reactive protein in patient with acute coronary syndrome

2017 ◽  
Vol 21 (4) ◽  
pp. 218-224 ◽  
Author(s):  
Ahmadnoor Abdi ◽  
◽  
Shafei Rahimi ◽  
Hossein Farshidi ◽  
Vahid VahdatKhah ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Low Dose ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome

Brain-derived neurotrophic factor is associated with coronary macrophage infiltrates in patients with acute coronary syndrome

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R.A Montone ◽  
M Camilli ◽  
M Russo ◽  
M Del Buono ◽  
F Gurguglione ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Neurotrophic Factor ◽  
Serum Levels ◽  
Brain Derived Neurotrophic Factor ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Protein Levels ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
St Segment

Abstract Background Brain-derived neurotrophic factor (BDNF) is a neurotrophine that plays a key role in the regulation of both central and peripheral nervous system. Moreover, BDNF is secreted in multiple tissues and exerts systemic, autocrine, and paracrine effects in the cardiovascular system. Of importance, BDNF expression was enhanced in macrophages and smooth muscle cells in atherosclerotic coronary arteries and may be involved in thrombus formation. Thus, BDNF has been suggested as an important link between inflammation and thrombosis, potentially involved in the pathogenesis of acute coronary syndrome (ACS). Purpose In our study we aimed at assessing serum levels of BDNF in patients with ACS, evaluating differences according to clinical presentation [ST-segment elevation myocardial infarction (STEMI) vs. Non-ST-segment elevation ACS (NSTE-ACS)]. Moreover, we assessed the presence of optical coherence (OCT)-defined macrophage infiltrates (MØI) in the culprit vessel of ACS patients and evaluated their relationship with BDNF levels. Methods ACS patients were prospectively selected. Blood samples were collected at admission and serum levels of BDNF were subsequently assessed. Presence of OCT-defined MØI along the culprit vessel was assessed. Results 166 ACS patients were enrolled [mean age 65.3±11.9 years, 125 (75.3%) male, 109 STEMI, 57 NSTE-ACS]. Serum levels of BDNF were higher among STEMI patients compared with NSTE-ACS [median (IQR) 2.48 pg/mL (1.54–3.34) vs. 2.12 pg/mL (1.34–2.47), p=0.007], while C-reactive protein levels did not differ between the two groups. OCT assessment was performed in 53 patients and MØI were detected in 27 patients. Of importance, patients with MØI in the culprit vessel had higher levels of BDNF compared with patients without MØI [median (IQR) 2.23 pg/mL (1.38–2.53) vs. 1.41 pg/mL (0.93–2.07), p=0.023], while C-reactive protein levels did not differ between the two groups. Of note, at multivariate regression analysis BDNF levels were independent predictor of MØI [OR: 2.20; 95% CI (1.02–4.74), p=0.043]. Conclusions Serum levels of BDNF may reliable identify the presence of local macrophage inflammatory infiltrates in patients with ACS. Moreover, BDNF levels are higher in patients with STEMI compared with NSTE-ACS. Taken together, these data suggest that BDNF may represent an interesting link between local inflammatory activation and enhanced thrombosis in ACS. BDNF serum levels Funding Acknowledgement Type of funding source: None

scholarly journals Serial Analyses of C-Reactive Protein and Myeloperoxidase in Acute Coronary Syndrome

2009 ◽  
Vol 32 (11) ◽  
pp. E58-E62 ◽  
Author(s):  
Flávia K. Borges ◽  
Fernando K. Borges ◽  
Steffan F. Stella ◽  
Juliana F. Souza ◽  
Andréa E. Wendland ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome

Tuberculosis in Children in a Pediatric Hospital in Mexico

2021 ◽  
Author(s):  
Napoleón González Saldaña ◽  
Mercedes Macías Parra ◽  
Hugo Juárez Olguín ◽  
José Iván Castillo Bejarano ◽  
Monica Punzo Soto ◽  
...  
Keyword(s):  
Pediatric Hospital ◽  
Diagnostic Challenge ◽  
Abnormal Chest ◽  
Culture Sensitivity ◽  
History Of ◽  
Chest X Ray ◽  
Epidemiological Evaluation ◽  
Polymerase Chain ◽  
Tuberculosis In Children ◽  
Skin Test Result

Tuberculosis (TB) remains a global problem and a diagnostic challenge, especially in pediatrics. The aim of this study was to describe the clinical, microbiological, radiological, and histopathological data of TB in children. A 7-year retrospective and descriptive cohort study that included 127 patients under 18 years of age with diagnosis of active TB was conducted from 2011 to 2018 in a pediatric hospital. Tuberculosis was microbiologically confirmed using Ziehl–Neelsen (ZN) staining, culture or polymerase chain reaction (PCR) in a total of 94 (74%) cases. Thirty-three cases were defined as probable TB based on tuberculin skin test result and epidemiological evaluation. The TB forms found were lymph node (39.3%), bone (15.7%), lung (13.6%), and meningeal TB (8.6%). The most common symptoms were fever (48.8%) and adenopathy (45.6%). History of contact was established in 34.6%. Positive ZN staining (sensitivity 30%) and culture (sensitivity 37%) were found in 29% and 37.7% of subjects, respectively. About 64.5% depicted abnormal chest X-ray. Xpert MTB/RIF® (PCR) was positive in 9.4% and biopsy was compatible in 52.7% of these samples. It is fundamental to have laboratory and epidemiological evaluation that support the diagnosis of the disease in children and thus, define its management; since, in most cases, early microbiologic confirmation is lacking.

scholarly journals Dissecting the Diagnosis – An Unusual Case of Pericarditis

2017 ◽  
Vol 16 (4) ◽  
pp. 200-203
Author(s):  
Louise Mundy ◽  
◽  
Purav Desai ◽  
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Unusual Case ◽  
Correct Diagnosis ◽  
Timely Manner ◽  
Medical Unit ◽  
Coronary Syndrome ◽  
Acute Medical Unit

Chest pain is an extremely common presenting complaint on the acute medical unit. It is important to distinguish between patients who have serious pathology and those without. Often, the focus is on ruling out an acute coronary syndrome and inadequate consideration is given to other possible causes. This case highlights the importance of performing relevant investigations in a timely manner, in order to ensure that a correct diagnosis is made.

scholarly journals THE FEATURES OF ATHEROSCLEROTIC PROCESS DEVELOPMENT AND ACUTE CORONARY SYNDROME COURSE IN PATIENTS WITHOUT DYSLIPIDEMIA

2017 ◽  
Vol 1 ◽  
pp. 17-24
Author(s):  
Valeriia Vataha
Keyword(s):  
Acute Coronary Syndrome ◽  
Blood Serum ◽  
Atherosclerotic Plaque ◽  
Ankle Brachial Index ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
St Segment ◽  
Atherosclerotic Process

The aim is to study the conditions of appearance and the features of course of the acute coronary syndrome (ACS) in patients with normal rates of lipid metabolism and to assess the influence of additional risk factors (uinary acid, C-reactive protein, fibrinogen) on the development of atherosclerotic process by assessment of surrogate markers of atherosclerosis the thickness of intima-media complex (TIMC) of carotid arteries (СА), the presence of atherosclerotic plaque (AP) in CA, the value of ankle-brachial index (ABI)) in patients with ACS without dyslipidemia (DLP). Materials and methods. The study included 66 patients without DLP (50 men and 16 women, the mean age - 53,7±10,6 years) with ACS, divided in groups depending on its forms: 1 group – patients with instable angina (IA), 2 group – patients with myocardium infraction (MI) without ST segment elevation and 3 group – patients with MI with ST segment elevation. The level of serum acid, C-reactive protein, fibrinogen in blood serum were detected and ultrasound examination of СА with detection of CA TIMC, presence of atherosclerotic plaque and measuring of arterial pressure on upper and low extremities with ABI calculation was carried out. Results. Among examined patients MI with ST segment elevation was diagnosed in 33 persons (50,0%); MI without ST segment elevation – in 18 (27,3%) and IA – in 15 (22,7%). The complicated ACS was observed in 20 (30,30%) persons. The value of CA TIMC among patients with MI with ST segment elevation was reliably higher than in patients with MI without ST segment elevation (р<0,001), and ABI was reliably lower in persons with MI and ST segment elevation (р<0,05) and IA (р<0,05) than in patients with MI without ST segment elevation. Correlative analysis demonstrated the interconnection between the levels of inflammation indicators (C-reactive protein, fibrinogen) in the blood serum and the value of CA TIMC and ABI. Conclusions. The persons without DLP need additional examination (detection of C-reactive protein, fibrinogen levels in blood serum, ultrasound of CA and detection of ABI) for more precise evaluation of ACS risk.

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