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Cardiac Masses
Published in Takahiro Shiota, 3D Echocardiography, 2020
Sonia Velasco del Castillo, Miguel Angel García-Fernández
Primary cardiac malignancies are less frequent than benign tumors and represent 20% of primary cardiac tumors, the most frequent being sarcomas. The clinical presentation can vary and depends on the location of the tumor. Precordial pain usually indicates a malignant rather than a benign process.
The cardiovascular system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
In the examination of the cardiovascular system, it is not usually helpful to percuss over the precordium, except to locate the position of the mediastinum. This is useful in cases where it may be displaced, for example chronic airflow limitation or right lung collapse. If you do not suspect mediastinal shift from the history or the tracheal position, do not percuss the position of the mediastinum.
Electrocardiography and arrhythmias
Published in Neil Herring, David J. Paterson, Levick's Introduction to Cardiovascular Physiology, 2018
Neil Herring, David J. Paterson
In clinical practice, an additional six electrodes, V1-V6, are placed across the chest for connection to the positive terminal of the voltmeter. All three limb leads are connected to the negative terminal to create a mid-chest reference point. The six precordial leads encircle the heart and ‘look' transversely across the chest. This is useful, because the wave of excitation travels in three dimensions, not just the frontal plane recorded through the limb leads. Leads V1 and V2 lie over the fourth intercostal space (ICS), immediately right and left of the sternum, respectively; they record right ventricle activity best. V3 is between V2 and V4. V4 is placed over the fifth ICS in the mid-clavicular line. V3 and V4 record interventricular septal activity best. V5 and V6 are at the same level in the anterior axillary and mid-axillary line, respectively, and record the left ventricular activity best.
Brugada syndrome
Published in Acta Cardiologica, 2021
Haarika Korlipara, Giridhar Korlipara, Srinivas Pentyala
The problem with relying on a single 12-lead ECG for the diagnosis of BrS is that only 2–4% of patients persistently demonstrate a spontaneous type I Brugada pattern on repeated ECGs [1]. Therefore, there is a proven need for multiple recorded ECGs to help with both the diagnosis and prognosis of BrS [54]. Other methods that can help with diagnosing BrS include the use of a Holter monitor and elevating the position of the right precordial leads. A 24 h Holter monitor help to better capture the daily fluctuations in the type-1 Brugada pattern such as during nocturnal bradycardia following a meal or upon standing. Studies have also shown that in those patients that had a normal baseline ECG but a type-1 Brugada pattern during drug challenge, 20% were later found to have a spontaneous type I pattern on Holter [1,20]. Elevating the position of the right precordial leads to the third and second intercostal spaces can help to better diagnose BrS because it can better assess the RVOT in the chest, which is where the pathophysiology of BrS is centred. Evidence supporting the use of both Holter monitor and elevated positioning of the right precordial leads in diagnosis of BrS comes from a study by Shimeno et al., which determined that, the sensitivity in diagnosing BrS increases from 25% (using a single 12-lead ECG) to 38% when using a 24 h Holter, and to 55% when a 24 h Holter with elevated leads method is used.[55].
Magnetic resonance-guided thermal ablation for small liver malignant tumor located on segment II or IVa abutting the heart: a retrospective cohort study
Published in International Journal of Hyperthermia, 2021
Xin-Chen Lin, Yuan Yan, Lin Lin, Qing-Feng Lin, Jian Chen, Zheng-Yu Lin, Jin Chen
No serious complications were observed in the study. Seven patients (29.2%) developed mild or moderate shoulder pain evaluated by Visual Analogue Scale (VAS), and 4 patients (16.7%) developed precordial discomfort postoperatively which improved after symptomatic and analgesic treatment. Regarding intraoperative complications, one patient (4.2%) had a small amount (pericardial viscera-parietal spacing 13 mm) of asymptomatic pericardial hemorrhage, and 3 patients (12.5%) had a small amount (widest diameter smaller than 10 mm) of crescent-shaped capsular hemorrhage displayed as hyperintense in T2WI and hypointense in T1WI (Table 2). There were no cases of massive pneumothorax, pericardial tamponade, arrhythmia, diaphragmatic perforation, liver failure, needle implant transfer, or ablation-related deaths.
Extracellular ubiquitin levels are increased in coronary heart disease and associated with the severity of the disease
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2020
Yiqun Ji, Jialu Yao, Yunxiao Zhao, Juping Zhai, Zhen Weng, Yang He
From December 2018 to April 2019, 67 consecutive patients, who underwent coronary angiography because of precordial pain and were diagnosed with CHD at Suzhou Municipal Hospital, were enrolled in this study; 60 healthy subjects undergoing physical examination without any signs of CHD were recruited as controls. Criteria of CHD patients included: (i) age ≥ 18 years old. (ii) the presence of ≥ 50% stenosis in one or more major coronary arteries identified by angiography. All patients were then divided into three groups as mentioned before [30]: stable angina pectoris (SAP) group, unstable angina pectoris (UAP) group and acute myocardial infarction (AMI) group. Patients were excluded if they suffered from other severe cardiovascular disease, acute or chronic infection, severe hepatic or renal dysfunction, malignancy, or autoimmune diseases. Baseline characteristics including age, gender, heart rate, blood pressure, history of hypertension, diabetes mellitus, hyperlipidemia, smoking and alcohol abuse were obtained from all patients at the time of admission. This study complied with the Declaration of Helsinki and was approved by the Institutional Ethics Committee of the Suzhou Municipal Hospital. All participants provided written informed consent.