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Chest Pain - Europe PMC

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Last Updated: 19 May 2022

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Association between troponin and outcome in patients with chest pain and rapid atrial fibrillation: a retrospective study of a single-center 10-year cohort.

Background and purpose The prognosis of myocardial infarction in patients with acute atrial fibrillation is uncertain. We wanted to see if troponin levels are associated with a high risk of major adverse cardiovascular events in patients with RAF and chest discomfort suggestive of coronary origin. Methods We retrospectively reviewed all prospective patients attending an emergency department of a single-center with chest pain suggestive of coronary origins, including RAF and at least one troponin determination. These were considered secondary outcomes in addition to cardiovascular disease and type I myocardial infarction. Troponin's influence as a continuous variable and results was also assessed, as well as interplay by sex. When tested consistently, an increase in troponin concentrations was largely correlated with a rise in the risk of MACE. In patients with RAF who complain of chest pain, elevated troponin levels are attributed to adverse cardiovascular outcomes.

Source link: https://europepmc.org/article/MED/35579514


Physician judgement in predicting obstructive coronary artery disease and adverse events in chest pain patients.

In estimating the danger in patients with suspected coronary artery disease, patients with suspected coronary artery disease should be compared to pretest probability scores. Both the high-likelihood and the intermediate-likelihood physician-estimated groups compared to the low-likelihood group, with a noticeable difference between the three groups; ESC differed between the three groups. The higher incidence of adjusted death/myocardial infarction/unstable angina hospitalization in the high-probability group versus low-probability groups was found among only doctor estimates; no prognostic data was provided; only doctor estimates were correlated with a higher risk of adjusted death/myocardial infarction/unstable angina hospitalization in the high-probability group versus low-probability group; neither prognostic data; no official statistics; neither prognost versus low-probability/unst angina hospitalization/unstable angina hospitalization versus low-probability group; no risk; no estimate; no versus low-probability cohort reported prognostibigraphic results; Patients with chronic chest pain can be prone to heart disease if they integrate physician judgment.

Source link: https://europepmc.org/article/MED/35110385


Risks of refractory chest pain after peroral endoscopic myotomy in achalasia-related esophageal motility disorders: short-term results from a multicenter study in Japan.

The cause and risk factors of persistent chest pain after percutaneous endoscopic myotomy remain unclear, as well as the etiology and risk factors of persistent chest pain following percutaneous endoscopic myotomy. Methods A multicenter cohort study of 14 hospitals was carried out to elucidate the characteristics of patients with chest pains and POEM's efficacy. Result Consecutive cases of AEMDs had 2,294 and 1,280 patients with and without chest pain, respectively. We observed complete relief in 6,464 patients and non-remission in 643 patients, with partial response in 619 patients and resistance in 24 patients among the 2,107 patients with chest pain who underwent POEM, as well as partial response in 24 patients. Conclusions: Chest pains are more prevalent and severe than HRM findings than RMI findings, as opposed to HRM findings.

Source link: https://europepmc.org/article/MED/35568241


The potential of new prediction models for emergency medical dispatch prioritisation of patients with chest pain: a cohort study.

When evaluating patients with chest pain, goal was to develop emergency medical dispatch center prediction software with high sensitivity and satisfaction. Methods Observational cohort study of 2917 unselected patients with chest pain who contacted an EMD center in Sweden due to chest pain during 2018. For the low-risk prediction model, the area under the receiver-operating characteristic curve was 0. 79, and for the low-risk model it was 0. 74. In both high- and low-risk forecasts, the new prediction tools exceeded today's dispatch priority accuracy in terms of sensitivity, as well as positive and negative predictive values in both high- and low-risk forecasts. When compared to today's average, the low-risk model predicted almost six times as many patients as having low-risk conditions. This will result in a more effective emergency medical services resource allocation.

Source link: https://europepmc.org/article/MED/35527302


Admission Triage With Pain, Inspiratory Effort, Cough Score can Predict Critical Care Utilization and Length of Stay in Isolated Chest Wall Injury.

Introduction Damage to the thoracic cage is common in the injured patient, both when the injuries are restricted to this single cavity and as part of the overall injury burden of a polytraumatized patient. In the local trauma registry, all isolated chest wall injuries from January 2020 to June 2021 were identified. Differential results between PIC score results and the recursive partitioning algorithm were used to determine the relationship between PIC scores and the recursive partitioning algorithm, which related admission PIC scores to ICU LOS. Two hundred and thirty six isolated chest wall injury patients were identified, of whom 194 were included in the final analysis. PIC score of 7 or lower was associated with ICU admission, but not anatomic injury severity score, hospital LOS, or ICU permeability were among the reasons for mechanical ventilation. PIC 7 for P = 0. 013 and PIC 6 for P = 0. 001. PIC 6 for P = 0. 001 is the most accurate cut point of the PIC score to forecast ICU admission over 48 h in our retrospective cohort. Conclusions Patients with isolated chest wall injuries require safe reproducible triage for ICU-level care. As determined by our estimated complication rate that calls for urgent care assistance, the PIC score appears to be a moderate discriminator of critical care need per se.

Source link: https://europepmc.org/article/MED/35533604


The effect of cold application on pain in patients with chest tubes before deep breathing and coughing exercises: A randomized controlled study.

Objects The aim of this randomized controlled trial was to investigate the effects of cold therapy in patients with chest tube problems before deep breathing and coughing exercises were undertaken. Findings After the deep breathing and coughing exercises, the participants' pain rates in the intervention group were lower than those before the exercises — better than the rates before the exercises. After the deep breathing and coughing exercises, the pain among the control group participants was noticeably higher than those before the workouts. Conclusions of the study The study found that cold therapy before deep breathing and coughing exercises effectively relieves pain in patients with chest tubes.

Source link: https://europepmc.org/article/MED/35533490


Sex and Race Differences in the Evaluation and Treatment of Young Adults Presenting to the Emergency Department With Chest Pain.

We investigated sex and racial disparities in the assessment of chest pain among young adults presenting to the emergency department. Methods and Results In the National Hospital Ambulatory Medical Care Survey 2014-to-2017, an emergency department visit for adults aged 18 to 55 years presenting with CP was deemed by an expert who surveyed stratified sampling to produce national estimates. Before and after multivariable change, we investigated links between sex, race, and CP management. Following multivariable change, people of color waited longer for physician evaluation than White adults, but there were no racial differences in hospital admission, triage level, electrocardiography, or cardiac biomarker testing. In 1. 4 percent of adults in the emergency department and 6. 5% of admitted adults, acute myocardial infarction was diagnosed in 1. 4% of adults and 6. 5% of admitted adults. Conclusions Women and people of color with CP waited longer to be seen by physicians than physicians, independent of clinical characteristics.

Source link: https://europepmc.org/article/MED/35506534


Incidence, diagnoses and outcomes of ambulance attendances for chest pain: A population-based cohort study.

One of the most common reasons for calls for ambulance assistance and places a large burden on health services is non-traumatic chest pain. Using a large population-based sample, this research sought to determine the prevalence, sex-specific incidences, diagnoses, and outcomes of patients with chest pain treated by paramedics by using a large population-based sample. The non-traumatic chest pain in Victoria, Australia, was present in consistent emergency medical services from January 2015 to June 2019. In 257,017 of 2,736,570 attendances, chest pain was the reason for calling EMS in 257,017 of 2,736,570. In regional settings and socioeconomically disadvantaged areas, the incidence of chest pain attendances increased with increasing age among females, among Aboriginal and Torres Strait Islanders, in regional settings, and in economically disadvantaged areas. Patients are released from hospital with a diagnosis of non-specific pain and low mortality.

Source link: https://europepmc.org/article/MED/35513303


Sex Differences in Identifying Chest Pain as Being of Cardiac Origin Using the HEART Pathway in the Emergency Department.

HEART Pathway is a diagnostic tool that can help identify low-risk patients with chest pain who can be safely discharged from the emergency department without hospitalization. A negative bias has been shown in identifying myocardial ischemia in females versus males in females, as well as a contrasting clinical pattern of cardiac ischemia in genders. Physicians in male and female patients with chest pain in 4/2014-7/2019 were compared to HEART Pathway protocol outcomes, according to HEART Pathway protocol predictions. 227 patients will be admitted and 545 discharged, according to the HEART Pathway protocol. Male sex was a significant factor in favoring admission among the patients for whom the HEART Pathway predicted acceptance in a regression model. Conclusions: As the HEART Pathway is a reliable risk-stratification system, a high risk of acute coronary artery disease may be overlooked in women, as well as those seeking urgent medical assistance.

Source link: https://europepmc.org/article/MED/35501966

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions