Objective: To assess the clinical presentation and evaluation of acute life-threatening chest pain in Accra, Ghana.
Design: This was a cross-sectional study at the emergency departments of two leading tertiary hospitals in Accra.
Settings: The study was conducted at the Korle-Bu Teaching Hospital and the 37 Military Hospital in Accra.
Participants: The study participants comprised adult patients aged 18 years and above who presented with acute chest pain at the emergency departments between April and June 2018.
Main Outcome: Acute coronary syndrome is the leading life-threatening cause of chest pain with poor pre- and in-hospital care.
Results: 232 patients with chest pain were enrolled as respondents aged 18 to 94 years. The prevalence of life-threatening conditions causing chest pain was 31.9% of those who presented with acute chest pain. These included acute coronary syndrome (82.4%), pulmonary embolism (14.9%), and acute chest syndrome (2.7%). A few (6.6%) with life-threatening conditions such as acute coronary syndrome were transported by ambulances, and 44.3% reported to the facility within 2 to 9 days after the onset of chest pain. None of the patients with pulmonary embolism and acute chest syndrome had computer tomography pulmonary angiogram (CTPA) and echocardiogram done, respectively.
Conclusion: Our study found that life-threatening conditions amongst patients presenting with acute chest pains are common; however, there is a need to improve pre-hospital care and in-hospital assessment of these cases.
Funding: The study was partly funded by the Medtronic Foundation.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11465723 | PMC |
http://dx.doi.org/10.4314/gmj.v58i3.8 | DOI Listing |
Best Pract Res Clin Anaesthesiol
March 2024
Department of Thoracic Surgery, Barts Thorax Centre, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK. Electronic address:
This review documents the importance of postoperative interventions that accelerate the functional recovery of the thoracic surgical patient. Enhanced recovery after surgery (ERAS) pathways aim to mitigate the harmful surgical stress response. Improvements to the entire patient pathway, by removing unnecessary care elements while introducing evidence-based interventions, have synergistic effects.
View Article and Find Full Text PDFCureus
December 2024
Department of Cardiovascular Medicine, University of Texas Health Science Center at Houston, Houston, USA.
We present a case of a 52-year-old male with no known past medical history who presented to an outside hospital with acute chest pain. Initial workup revealed anteroseptal ST-elevation myocardial infarction (STEMI) for which the patient was transferred to our facility for emergent percutaneous coronary intervention (PCI). However, the patient's hospital course revealed numerous confounding pathologies that can also present as STEMI, including transthoracic echocardiogram (TTE) abnormalities consistent with takotsubo cardiomyopathy (TCM) as well as myocardial bridging presenting as post-PCI STEMI in the setting of nitroglycerin use.
View Article and Find Full Text PDFFront Cardiovasc Med
December 2024
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Background: Acute aortic dissection is a lethal cardiovascular emergency; early diagnosis is critically necessary. Novel serum biomarkers can potentially help in early detection and estimation of postoperative outcomes. Yes-associated protein (YAP) is a critical effector of the Hippo pathway, our aim was to explore the association between YAP and the diagnosis and prognosis of AD.
View Article and Find Full Text PDFAm J Case Rep
January 2025
Department of General Medicine, Juntendo University Faculty of Medicine, Bunkyo, Tokyo, Japan.
BACKGROUND Mondor's disease (MD), or sclerosing superficial thrombophlebitis of the veins of the anterior thoracic wall, is a rare condition of unknown cause that usually involves the superior epigastric vein, producing a visible and palpable Mondor cord. This report describes a 27-year-old Japanese woman presenting with left chest wall pain due to palpable and visible sclerosing superficial thrombophlebitis. CASE REPORT We present the case of a 27-year-old Japanese woman who presented with 8 days of left chest wall and upper abdominal pain.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Department of Heart Surgery, East Slovak Institute for Cardiovascular Diseases, Ondavská 8, Košice, 040 12, Slovakia.
Background: The left internal thoracic artery (LITA) has been widely accepted as the standard for revascularizing the left anterior descending artery during coronary artery bypass grafting (CABG) surgery. However, in 10-20% of cases, the LITA may lead to unsecured side branches to the chest wall, particularly the lateral costal artery (LCA), potentially resulting in postoperative chest angina.
Case Presentation: We report the case of a 58-year-old patient who experienced persistent angina eight months after having undergone coronary artery bypass grafting (CABG) due to the steal phenomenon caused by a thick lateral costal artery (LCA).
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