scholarly journals 50-year-old Male With Chest Pain

2019 ◽  
Vol 3 (4) ◽  
pp. 321-326
Author(s):  
William Fernandez ◽  
Laura Bontempo ◽  
Zachary Dezman
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Chest Pain ◽  
Troponin I ◽  
Shortness Of Breath ◽  
Upper Limit ◽  
Work Up

A 50-year-old male presented to the emergency department with four days of intermittent chest pain and shortness of breath, which progressively worsened in severity. Testing revealed a troponin I greater than 100 times the upper limit of normal and an electrocardiogram with non-specific findings. This case takes the reader through the differential diagnosis and systematic work-up of the deadly causes of chest pain, ultimately leading to this patient’s diagnosis.

scholarly journals Tracheal Lipoma Mimicking Asthma

2021 ◽  
Vol 24 (12) ◽  
pp. 916-918
Author(s):  
Barış Çil ◽  
Mehmet Kabak
Keyword(s):  
Emergency Department ◽  
Differential Diagnosis ◽  
Chest Pain ◽  
Rare Condition ◽  
Chest Ct ◽  
Benign Tumors ◽  
Shortness Of Breath ◽  
Treatment Resistant ◽  
Chest Ct Scan ◽  
Tracheal Tumors

Primary tracheal tumors are very rare and 10%–20% are benign tumors. Tracheal lipoma is extremely rare and only a few cases have been reported in the literature. A 69-year-old male patient presented to the emergency department with complaints of shortness of breath, respiratory distress, chest pain and cough. Chest CT scan showed a round mass in the topography of the trachea that almost caused airway obstruction. The lesion was resected endoscopically and the pedicle base was cauterized. Tracheal lipoma is a rare condition that should lie in the differential diagnosis of treatment-resistant asthma.

The Impact of Pregnancy on the Work-Up of Chest Pain and Shortness of Breath in the Emergency Department [14Q]

2017 ◽  
Vol 129 ◽  
pp. 176S-177S
Author(s):  
Stephen Wagner ◽  
Ian Waldman ◽  
Allen R. Kunselman ◽  
Emily Smith ◽  
Timothy Deimling
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Shortness Of Breath ◽  
The Impact ◽  
Work Up

Myocarditis case associated with Campylobacter jejuni

2018 ◽  
Vol 43 (5) ◽  
pp. 568-570
Author(s):  
Hakan Ayyildiz ◽  
Mehmet Kalayci ◽  
Nadire Cinkilinc ◽  
Mahmut Bozkurt ◽  
Makbule Kutlu Karadag
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Campylobacter Jejuni ◽  
Bacterial Infections ◽  
Troponin I ◽  
Normal Sinus Rhythm ◽  
Cardiac Enzymes ◽  
Normal Sinus ◽  
Anterior Hemiblock ◽  
High Sensitive Troponin

Abstract Objective Myocarditis is an inflammatory disease of the heart caused by various agents and especially enteroviruses, and it is difficult to diagnose and treat. Myocarditis is rarely associated with bacterial infections. Although the most common bacterial infections are Salmonella spp. and Shigella spp., extremely rare cases of Myocarditis due to Campylobacter jejuni are also reported. Patient and methods A 17-year-old male patient with no previous chronic illness was admitted to our emergency department with complaints of abdominal pain, diarrhea, vomiting, and chest pain. He stated that symptoms began after eating a chicken burger a few days ago. Results In the laboratory tests performed, CK-MB and high sensitive Troponin I values were determined as 33.8 IU/L and 1816 ng/L, respectively. Electrocardiogram results revealed left axis left anterior hemiblock in the normal sinus rhythm as well as a ST-T change in the inferior and lateral derivations. Campylobacter jejuni was detected in the stool sample of the patient. Conclusion Myocarditis is one of the rare complications of C. jejuni infection. Bacterial myocarditis should be considered when troponin and cardiac enzymes are elevated in patients admitted to the emergency department with diarrhea and chest pain.

scholarly journals Meningococcemia Presenting as a Myocardial Infarction

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Daniel Lachant ◽  
David Trawick
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Chest Pain ◽  
Cardiogenic Shock ◽  
Neisseria Meningitidis ◽  
Early Recognition ◽  
Myocardial Dysfunction ◽  
Shortness Of Breath ◽  
Gram Negative ◽  
St Elevation

Neisseria meningitidisis an encapsulated gram negative diplococcus that colonizes the nasopharynx and is transmitted by aerosol or secretions with the majority of cases occurring in infants and adolescents. Meningococcemia carries a high mortality which is in part due to myocarditis. Early recognition and prompt use of antibiotics improve morbidity and mortality. We report a 55-year-old male presenting to the emergency department with chest pain, shortness of breath, and electrocardiogram changes suggestive of ST elevation MI who developed cardiogenic shock and multisystem organ failure fromN. meningitidis. We present this case to highlight the unique presentation of meningococcemia, the association with myocardial dysfunction, and the importance of early recognition and prompt use of antibiotics.

P2673Challenging time limits: Using a single high-sensitive troponin I to rule-out acute myocardial infarction in early presenters

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Hansen ◽  
C Bang ◽  
K G Lauridsen ◽  
C A Frederiksen ◽  
M Schmidt ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Emergency Department ◽  
Chest Pain ◽  
Troponin I ◽  
Regional Hospital ◽  
Late Presenters ◽  
Siemens Healthcare ◽  
High Sensitive Troponin ◽  
Rule Out

Abstract Introduction According to ESC guidelines, an acute myocardial infarction (MI) can be excluded without serial troponin measurements in patients presenting with a single high-sensitive troponin below the 99th percentile and chest pain starting >6 hours prior to admission. However, it is unclear if single-testing of high-sensitive troponin can rule-out MI in early presenters. Purpose To investigate the diagnostic performance of a single value of high-sensitive cardiac troponin I (hs-cTnI) at presentation for ruling-out MI in patients presenting with chest pain to the Emergency Department irrespective of chest pain onset. Methods We conducted a substudy of preliminary data from the RACING-MI trial. We included patients presenting with chest pain suggestive of MI to the Emergency Department of a Regional Hospital. We used the Siemens hs-cTnI (Siemens Healthcare, TNIH, Limit of detection: 2.21 ng/L) and a diagnostic cut-off value <3 ng/L to rule-out MI at presentation. Two physicians independently adjudicated the final diagnosis based on all clinical information. Patients were stratified based on time from chest pain onset to hospital admission as very early (0–3 hours), early (3–6 hours) and late presenters (>6 hours). Results We included 989 patients with available hs-cTnI results at admission. MI was confirmed in 82 (8.3%) patients. Using hs-cTnI <3 ng/L as diagnostic cut-off value at presentation, 302 (30.5%) patients without MI were classified as rule-out. Overall, the negative predictive value (NPV) for MI was 100% (95% CI 98.7–100). Based on chest pain onset, 33.8% of patients were classified as very early, 12.8% as early, and 42.7% as late presenters, with 10.7% patients with unreported/unknown onset. NPV was 100% (95% CI 96.5–100) for very early, 100% (95% CI 88.3–100) for early and 100% (95% CI 97.3–100) for late presenters. Conclusions Using a single hs-cTnI value <3ng/L as diagnostic cut-off to rule-out MI seems to be safe and to allow rapid rule-out of MI in patients presenting with chest pain to the emergency department, even in very early presenters. ClinicalTrials.gov Identifier: NCT03634384. Acknowledgement/Funding Randers Regional Hospital, A.P Møller Foundation, Boserup Foundation, Korning Foundation, Højmosegård Grant, Siemens Healthcare (TNIH assays), etc.

Sensitive Troponin I and Stress Testing in the Emergency Department for the Early Management of Chest Pain Using 2-Hour Protocol

2017 ◽  
Vol 16 (3) ◽  
pp. 89-92
Author(s):  
Shahriar Dadkhah ◽  
Zakaria Almuwaqqat ◽  
Samian Sulaiman ◽  
Husein Husein ◽  
Quang Nguyen ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Stress Testing ◽  
Troponin I ◽  
Early Management

scholarly journals Just the Facts: Protected code blue – Cardiopulmonary resuscitation in the emergency department during the coronavirus disease 2019 pandemic

CJEM ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 431-434 ◽  
Author(s):  
Sarah McIsaac ◽  
Randy S. Wax ◽  
Brit Long ◽  
Christopher Hicks ◽  
Christian Vaillancourt ◽  
...  
Keyword(s):  
Patient Outcome ◽  
Emergency Department ◽  
Chest Pain ◽  
Cardiopulmonary Resuscitation ◽  
Emergency Medical Services ◽  
Negative Pressure ◽  
Shortness Of Breath ◽  
Code Blue ◽  
Palpable Pulse ◽  
History Of

Emergency medical services (EMS) is called for a 65-year-old man with a 1-week history of cough, fever, and mild shortness of breath now reporting chest pain. Vitals on scene were HR 110, BP 135/90, SpO2 88% on room air. EMS arrives at the emergency department (ED). As the patient is moved to a negative pressure room, he becomes unresponsive with no palpable pulse. What next steps should be discussed in order to protect the team and achieve the best possible patient outcome?

scholarly journals Comparison of Myocardial Perfusion Imaging and Cardiac Troponin I in Patients Admitted to the Emergency Department With Chest Pain

Circulation ◽  
1999 ◽  
Vol 99 (16) ◽  
pp. 2073-2078 ◽  
Author(s):  
Michael C. Kontos ◽  
Robert L. Jesse ◽  
F. Philip Anderson ◽  
Kristin L. Schmidt ◽  
Joseph P. Ornato ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Myocardial Perfusion Imaging ◽  
Myocardial Perfusion ◽  
Perfusion Imaging ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I
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