Aims: Troponin measurement is used in the assessment and risk stratification of patients presenting acutely with chest pain when the main cause of elevation is coronary artery disease. However, some patients have no coronary obstruction on angiography, leading to diagnostic uncertainty. We evaluated the incremental diagnostic value of cardiovascular magnetic resonance (CMR) in these patients.
Methods And Results: Sixty consecutive patients (mean age 44 years, 72% male) with a troponin-positive episode of chest pain and unobstructed coronary arteries were recruited within 3 months of initial presentation. All patients underwent CMR with cine imaging, T2-weighted imaging for detection of inflammation, and late gadolinium enhancement imaging for detection of infarction/fibrosis. An identifiable basis for troponin elevation was established in 65% of patients. The commonest underlying cause was myocarditis (50%), followed by myocardial infarction (11.6%) and cardiomyopathy (3.4%). In the 35% of patients where no clear diagnosis was identified by CMR, significant myocardial infarction/fibrosis was excluded.
Conclusion: CMR is a valuable adjunct to conventional investigations in a diagnostically challenging and important group of patients with troponin-positive chest pain and unobstructed coronary arteries.
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http://dx.doi.org/10.1093/eurheartj/ehm113 | DOI Listing |
J Clin Med
December 2024
Department of Pharmacy, CHOC Children's Hospital, Orange, CA 92868, USA.
: Cannabinoid Hyperemesis Syndrome (CHS), associated with long-term cannabinoid use, has been increasingly observed in emergency room visits as more states in the U.S. have legislatively permitted medical and recreational marijuana use.
View Article and Find Full Text PDFJ Clin Med
December 2024
Department of Rheumatology, School of Medicine, Collegium Medicum, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland.
The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a rare condition caused by an immune response associated with over-reactivity of the immune system, triggered by adjuvants. The most common adjuvants are aluminium salts but can also be bioimplants or infectious agents. It may lead to the development of various autoimmunologic diseases.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2024
Department of Computer Science, Tunghai University, Taichung 407224, Taiwan.
Background And Objective: Cardiovascular disease (CVD), one of the chronic non-communicable diseases (NCDs), is defined as a cardiac and vascular disorder that includes coronary heart disease, heart failure, peripheral arterial disease, cerebrovascular disease (stroke), congenital heart disease, rheumatic heart disease, and elevated blood pressure (hypertension). Having CVD increases the mortality rate. Emotional stress, an indirect indicator associated with CVD, can often manifest through facial expressions.
View Article and Find Full Text PDFJ Transl Med
January 2025
Department of Cardiology, The 904th Hospital of the PLA Joint Logistics Support Force, Wuxi, Jiangsu, 214044, People's Republic of China.
Objective: This study aims to develop a novel risk assessment tool for coronary artery disease (CAD) based on data of patients with chest pain in outpatient and emergency department, thereby facilitating the effective identification and management of high-risk patients.
Methods: A retrospective analysis was conducted on patients hospitalized for chest pain. Patients were divided into a control group and a CAD group based on angiographic results.
J Cardiothorac Surg
January 2025
Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
Background And Aim: Removing the chest tube in cardiac patients after surgery is one of the worst experiences of hospitalization in the intensive care units. Various pharmacological and non-pharmacological methods are available to control pain in these patients. This study aimed to investigate the combined effect of reflexology massage and respiratory relaxation on pain following chest tube removal in cardiac surgery patients of Shahid Beheshti Hospital in Shiraz, Iran, in 2023.
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