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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.
Stroke and Transient Ischemic Attacks of the Brain and Eye
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Other features of SAH include: Vomiting (75%).Depressed consciousness (67%).Focal neurologic signs (15%).Intraocular subhyaloid hemorrhages (linear or flame-shaped hemorrhages in the preretinal layer (Figure 12.12) (14%).Epileptic seizures (7%).Delirium (1%).Radicular or precordial pain (spinal SAH).Severe hypertension.Electrocardiographic changes that can mimic those of acute myocardial infarction (MI).
Cardiac Trauma
Published in Karim Ratib, Gurbir Bhatia, Neal Uren, James Nolan, Emergency Cardiology, 2010
Karim Ratib, Gurbir Bhatia, Neal Uren, James Nolan
Cardiac contusion is considered the most common injury to the heart following blunt trauma. Cardiac contusion usually produces no significant symptoms and can easily go unrecognized. Subepicardial and subendocardial petechiae, bruising, haematoma, lacerations and full-thickness myocardial damage, later followed by necrosis, fibrosis and aneurysm formation, can occur. The key symptom is precordial pain resembling that of myocardial infarction (MI) but unrelieved with nitrates. Other sites of chest trauma may confuse the clinical picture, but unlike injury to the thoracic wall, pain from cardiac contusion is not affected by breathing. There may be inappropriate tachycardia, gallop rhythm and a pericardial rub. The electrocardiogram (ECG) may show non-specific ST-T wave changes (Figure 10.1), findings of pericarditis, loss of R-wave amplitude and even pathological Q waves depending on the degree of injury. Localized injury to the conducting system can give rise to varying degrees of atrioventricular (AV) block, intraventricular conduction defects or bundle branch block. Supraventricular tachycardias, atrial fibrillation (AF), atrial and ventricular ectopics, ventricular tachycardia (VT) and ventricular fibrillation (VF) can also occur.
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.
Application of oxytocin in ultrasound-guided percutaneous microwave ablation for treatment of hypervascular uterine fibroids: a preliminary report
Published in International Journal of Hyperthermia, 2019
Yajie Fu, Qingliang Feng, Shihong Zhang, Yongjie Li
In the oxytocin group, four drug-related adverse reactions occurred, including one case of prickling precordial pain, and three cases of facial flushing, increased heart rate and dizziness that were alleviated after slowing the oxytocin drip rate. There were six cases of adverse reactions related to microwave therapy during the procedure, all of which involved lower abdominal distension and pain, and which disappeared after treatment. In the control group, there were five cases of lower abdominal distension and pain, and no adverse drug reactions occurred. All cases of abdominal pain in both groups were treated with sufentanil 0.1 µg/kg by the anesthesiologist via slow intravenous injection, and the pain was significantly relieved. Vaginal secretions (fluid discharge from the vagina) occurred in both groups after ablation, including eight and six cases in the oxytocin and control groups, respectively. All vaginal secretions consisted of a small amount of light yellow or bloody fluid. Patients were advised to clean the perineum and take prophylactic anti-inflammatory drugs orally for 5 days, and all vaginal secretions resolved after 6–21 days.
U.S. Hospitalization rates and reasons stratified by age among persons with HIV 2014–15
Published in AIDS Care, 2020
Julia Fleming, Stephen A. Berry, Richard D. Moore, Ank Nijhawan, Charurut Somboonwit, Laura Cheever, Kelly A. Gebo
Lastly, we modified the CCS classification in several ways. First, we constructed a separate category for ADI by reassigning appropriate admissions according to individual ICD-9 codes as per the 1993 Centers for Disease Control and Prevention Revised Classification (“1993 revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults,” 1992). Recurrent bacterial pneumonia was defined as an admission for bacterial pneumonia >30 days and <365 days from prior hospitalization for bacterial pneumonia. Next, the CCS assigns many infections to an organ system category rather than to the infection category. We reassigned ICD-9 codes falling into the following CCS sub-levels to the infection category: central nervous system infection; infection of the eye; otitis media; endocarditis; respiratory infection; empyema; intestinal infection; appendicitis; anal and rectal conditions; diverticulitis; peritonitis and intestinal abscess; urinary tract infections; liver abscess; inflammatory conditions of the genitals; infections of genitourinary tract during pregnancy; infectious and parasitic complications in mother affecting pregnancy; skin and subcutaneous tissue infections; infective arthritis and osteomyelitis; infection and inflammation of an internal prosthesis; postoperative infection. We also reassigned alcoholic cirrhosis (571.2) and alcoholic gastritis (535.31) from psychiatric to gastrointestinal/liver, and hypertensive chronic kidney disease (403.00–403.91) from cardiovascular to renal/genitourinary. In order to determine the most frequent individual diagnoses within each category, frequently-appearing individual ICD-9 codes were explored using an online ICD-9 description tool (“Free only searchable 2009 ICD-9-CM. http://icd9.chrisendres.com/ Accessed June 9, 2018.”). Where appropriate, we grouped highly-similar codes into individual diagnosis groups. For example, within the cardiovascular category, unspecified chest pain (786.50), precordial pain (786.51) and discomfort, pressure, or tightness in the chest (786.59) were grouped together as “chest pain”.