• 제목/요약/키워드: Acute chest pain

검색결과 141건 처리시간 0.024초

한양방 협진 치료를 통해 호전을 보인 주상(酒傷)으로 인한 급성 복통 환자 1례 (A Case Report of Patient with Alcoholic Derogation Acute Abdominal Pain Using Oriental Medicine Combined with Conventional Treatment)

  • 김상범;박재우;조종관;이연월;유화승
    • 혜화의학회지
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    • 제21권1호
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    • pp.79-85
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    • 2012
  • Objective : This study was aimed to report a patient accompanied by alcoholic derogation acute abdominal pain treated with oriental medicine combined with conventional treatment. Methods : A 36 year old female patient complained of acute abdominal pain for one year from Apr. 2009. She had treated at local general hospital. But the symptom was not reduced. Instead, it was aggravated on Jul. 2010. The main symptoms were left flank pain, chest discomfort, nausea and anorexia. The patient was treated by oriental medicine (herbal medicine (Chunggan-plus), acupuncture, moxibustion, etc) combined with conventional medicine from Jul. 10th, 2010 to Jul. 17th, 2010. We observed the patient with evaluation of laboratory test and imaging scan. Results : Most of the symptoms of the patient were improved. Especially, the abdominal pain were disappeared from grade 3 to grade 0. No side effects were noted during treatment. Conclusion : This results suggest that the oriental medicine combined with western medicine may effective to treat alcoholic derogation acute abdominal pain.

불안정형 협심증의 관상동맥 우회수술치험 1 (Aorto-coronary Bypass for Unstable Angina - one case report -)

  • 김형묵
    • Journal of Chest Surgery
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    • 제20권2호
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    • pp.393-398
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    • 1987
  • Unstable angina pectoris is often premonitory to an acute myocardial infarction. Surgical revascularization in this syndrome is of great potential benefit and relatively low mortality. A patient with unstable angina pectoris is reported. A 65-year-old man complained of dyspnea and pain in the left anterior chest. The pain was brought on by mild exercise, occurred at rest and sleeping time. The pain worsened over a month period and more aggravated in intensity and duration. Physical examination showed no abnormalities except hypertension and laboratory data were within normal limits. His anginal pain was not relived by nitroglycerin ingestion. Preoperative coronary angiograms revealed significant obstruction [>90%] of left anterior descending coronary artery. Aorto-left anterior descending coronary bypass with autogenous saphenous vein used as conduit was performed. The postoperative course was uneventful and he was discharged on 16th postoperative day in a healthy condition.

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A형 간염에 동반된 흉막 삼출 1예 (A Case of Pleural Effusion Associated with Acute Hepatits A)

  • 김동일;박재옥;김창휘
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제8권2호
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    • pp.243-246
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    • 2005
  • 급성 A형 간염에서 흉막 삼출은 드물게 발생하는 합병증으로 불리한 예후인자는 아니며 대개는 양성의 경과를 취한다. 저자들은 전신쇠약과 황달로 내원한 12세 여아에게서 A형 간염에 동반된 흉막 삼출을 진단 하였고 특별한 치료 없이 안정 후에 호전된 1예를 경험하였기에 보고하는 바이다.

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Idiopathic acute eosinophilic pneumonia in a 14-month-old girl

  • Park, Ha Neul;Chung, Bo Hyun;Pyun, Jung Eun;Lee, Kwang Chul;Choung, Ji Tae;Lim, Choon Hak;Yoo, Young
    • Clinical and Experimental Pediatrics
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    • 제56권1호
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    • pp.37-41
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    • 2013
  • Idiopathic acute eosinophilic pneumonia (IAEP), characterized by acute febrile respiratory failure associated with diffuse radiographic infiltrates and pulmonary eosinophilia, is rarely reported in children. Diagnosis is based on an association of characteristic features including acute respiratory failure with fever, bilateral infiltrates on the chest X-ray, severe hypoxemia and bronchoalveolar lavage fluid >25% eosinophils or a predominant eosinophilic infiltrate in lung biopsies in the absence of any identifiable etiology. We present a 14-month-old girl who was admitted to our pediatric intensive care unit because of acute respiratory distress. She had a fever, dry cough, and progressive dyspnea for 1 day. Chest X-ray showed multifocal consolidations, increased interstitial markings, parenchymal emphysema and pneumothorax. IAEP was confirmed by marked pulmonary infiltrates of eosinophils in the lung biopsy specimen. Most known causes of acute eosinophilic pneumonia, such as exposure to causative drugs, toxins, second-hand smoking and infections were excluded. Her symptoms were resolved quickly after corticosteroid therapy.

급성 심근경색후 좌심실벽 파열 -2례보고- (Postinfarction Left Ventricular Free Wall Rupture)

  • 김도균
    • Journal of Chest Surgery
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    • 제33권10호
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    • pp.834-838
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    • 2000
  • Left ventricular free wall rupture following acute myocardial infarction (AMI) is the second most common cause of death and has been reported to be responsible for 4 to 24% of all infarction deaths. The rupture occurs anywhere from a few hours to several days after AMI. The common findings of ventricular rupture are persistent chest pain bradycardia and shock. This may be often mistaken for the ruptured dissection of the ascending aorta. The different points from dissection are 1) persistent chest pain 2)persistent ST segment elevation and 3) only intramural hematoma in ascending aorta. We have sucessfully managed two patients with postinfarction myocardial rupture. Surgical management consisted of infarctectomy repairi of the ventricular rupture and coronay artery bypass grafting. We conclude that successful surgical management of ventricular free wall rupture should require prompt diagnosis and emergency operation.

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급성 B형간염 환자에 대한 치험 1례(例) (A Case Report of Acute Hepatitis B)

  • 심국진;심하나;김유경;안기영;이진구;송봉근;박형진
    • 대한한방내과학회지
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    • 제25권4호
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    • pp.212-220
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    • 2004
  • A 36 year-old female patient with acute hepatitis B was treated with modified Chunggangunbi-tang. The patient complained of right arm and numbness, chest pain and discomfort, pain in the right chest, fever, athalpia, indigestion, fatigue, pruritus, jaundice and other minor problems. Two weeks later, symptoms has gone from severe to mild and transaminase level was lower. The medicine was prescribed for four more weeks and symptoms disappeared. The transaminase level fell to within normal range with no side effect. The Chunggangunbi-tang showed desirable effect on indigestion and more rapid recovery of liver function than previous reports on treatment for hepatitis. Finally results from clinicopathological examinations(about AST, ALT, total bilirubin, direct bilirubin, etc.) were promising. o we hope that this clinical study is helpful in treating patients with hepatic disease. Result suggests that oriental medical therapy is useful in treating acute hepatitis type B. More study and development of approach and application of this treatment for acute hepatitis type B are necessary.

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Prognostic significance of non-chest pain symptoms in patients with non-ST-segment elevation myocardial infarction

  • Kim, Inna;Kim, Min Chul;Park, Keun Ho;Sim, Doo Sun;Hong, Young Joon;Kim, Ju Han;Jeong, Myung Ho;Cho, Jeong Gwan;Park, Jong Chun;Cho, Myeong Chan;Kim, Jong Jin;Kim, Young Jo;Ahn, Youngkeun
    • The Korean journal of internal medicine
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    • 제33권6호
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    • pp.1111-1118
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    • 2018
  • Background/Aims: Chest pain is an essential symptom in the diagnosis of acute coronary syndrome (ACS). One-third of patients with ACS present atypically, which can influence their receiving timely lifesaving therapy. Methods: A total of 617 NSTEMI patients from the Korea Acute MI Registry (KAMIR) and the Korea Working Group on MI (KorMI) databases were analyzed. The study population was divided into two groups by symptoms at presentation (typical symptoms group, 128; atypical symptoms groups, 128). Results: In this study population, 23% of patients presented without chest pain. After propensity score matching, the contact-to-device time ($2,618{\pm}381minutes$ vs. $1,739{\pm}241minutes$, p = 0.050), the symptoms-to-balloon time ($3,426{\pm}389minutes$ vs. $2,366{\pm}255minutes$, p = 0.024), and the door-to-balloon time ($2,339{\pm}380minutes$ vs. $1,544{\pm}244minutes$, p = 0.002) were significantly higher in the patients with atypical symptoms than in those with typical symptoms, respectively. Atypical symptoms were an independent predictor for 1-year mortality (hazard ratio, 2.820; 95% confidence interval, 1.058 to 7.515; p = 0.038). The Kaplan-Meier estimates showed higher risk for 12-month mortality in patients with atypical symptoms (p = 0.048) and no significant difference for 12-month major adverse cardiac events (p = 0.487). Conclusions: Acute myocardial infarction patients with atypical symptoms were not rare in clinical practice and showed a high risk of delayed reperfusion therapy. After imbalance between the groups was minimized by use of propensity score matching, patients who presented atypically had a high mortality rate.

Modification of HEART Pathway for Patients With Chest Pain: A Korean Perspective

  • Bora Chae;Shin Ahn;Youn-Jung Kim;Seung Mok Ryoo;Chang Hwan Sohn;Dong-Woo Seo;Won Young Kim
    • Korean Circulation Journal
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    • 제53권9호
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    • pp.635-644
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    • 2023
  • Background and Objectives: The History, Electrocardiography, Age, Risk factors, and Troponin (HEART) pathway was developed to identify patients at low risk of a major adverse cardiac event (MACE) among patients presenting with chest pain to the emergency department. Methods: We modified the HEART pathway by replacing the Korean cut-off of 25 kg/m2 with the conventional threshold of 30 kg/m2 in the definition of obesity among risk factors. The primary outcome was a MACE within 30 days, which included acute myocardial infarction, primary coronary intervention, coronary artery bypass grafting, and all-cause death. Results: Of the 1,304 patients prospectively enrolled, MACE occurred in 320 (24.5%). The modified HEART pathway identified 37.3% of patients as low-risk compared with 38.3% using the HEART pathway. Of the 500 patients classified as low-risk with HEART pathway, 8 (1.6%) experienced MACE, and of the 486 low-risk patients with modified HEART pathway, 4 (0.8%) experienced MACE. The modified HEART pathway had a sensitivity of 98.8%, a negative predictive value (NPV) of 99.2%, a specificity of 49.0%, and a positive predictive value (PPV) of 38.6%, compared with the original HEART pathway, with a sensitivity of 97.5%, a NPV of 98.4%, a specificity of 50.0%, and a PPV of 38.8%. Conclusions: When applied to Korean population, modified HEART pathway could identify patients safe for early discharge more accurately by using body mass index cut-off levels suggested for Koreans.

매핵기(梅核氣)의 형상의학적(形象醫學的) 고찰(考察) (Review on the Globus Hystericus in View of Hyungsang Medicine)

  • 정흥식;이용태
    • 동의생리병리학회지
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    • 제20권3호
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    • pp.516-521
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    • 2006
  • The following conclusions are drawn from Hyungsang medicinal review on th globs hystericus through Donguibogam and other literatures. The globs hystericus appears in the throat and the epigastric region. It is a subjective sensation as if a plum pit is stick in the throat and is compressed, usually ac companied by stuffiness in chest, depression, nausea, and hiccup. But the throat is not marked with redness and swelling. Because Gi stagnation due to seven emotions is the main cause, the globs hystericus is usually followed by Seven Gi injuries, Pain and depressive syndrome due to disorder of Gi, palpitation due to fright, continuous violent palpitation, Gi phlegm, precordial pain with palpitation, epigastric pain due to seven emotions, cough and dyspnea due to disorder of Gi, and six kinds of stagnations. When head and body or chest and abdomen is compared to heaven and earth, the blockage of Gi between heaven and earth is common to the persons with the following charcteristics in Hyungsang; Dam type rather than Bankwang type, Gi type and Shin type rather than deer type and fish type, Taeum and Yangmyeong meridian types out of six meridian types, manly women, womanly man, too long or short neck, and signs of stagnation between the eyebrows. The globus hystericus needs, distinguishing from aphonia, acute tonsilitis, goiter, and pectorial pain with stuffiness. The affected area of aphonia and acute tonsilitis is the throat but they are not cause by the disturbance of seven emotions. Goiter can be distinguished by the changes in the appearance of neck. Even though the symptoms are similar, globus hystericus is caused by the stagnation of Gi, but the pectorial pain with stuffiness, by the insufficiency of the Heart blood. The general prescriptions are Chilgitang, Sachiltang, Gamisachiltang, Gamiijintang, and Sinihwan.

말초동맥 전색에 대한 혈전 제거술 (3례) (Embolectomy in Peripheral Arteries: 3 Cases)

  • 정영환;김공수;김근호
    • Journal of Chest Surgery
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    • 제3권1호
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    • pp.31-38
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    • 1970
  • This is a report of three cases of successful embolectomy in peripheral arteries. First case was the patient who received a mitral commissurotomy 8 months ago. In that time, there was no evidence of left atrial thrombosis. He showed an embolism in the middle portion of left brachial artery without complaining of any ischemic pain. Embolectomy was performed 15 days after disappearance of radial pulse and resulted in no return of radial pulse postoperatively. Second case was a case of an embolism in lower portion of right brachial artery. She complained severe ischemic pain and cyanosis in the right forearm and fingers. She was also in the beginning state of cardiac failure, which was suspected from her hypertension associated with cardiomegaly and arrythmia Embolectomy was performed 17 hours after onset of acute pain. Immediate full pulsation of radial artery was obtained after embolectomy and the acute ischemic symptoms subsided gradually. Third case was an embolism in superior mesenteric artery which occured 24 hours after pneumonectomy for right bronchogenic carcinoma and the patient suddenly complained diffuse abdominal colicky pain. 7 hours after attack of abdominal pain. embolectomy with extensive reset ion of the small intestine was performed with uneventful recovery and without complication, such as short bowel syndrome, postoperatively. Histopathologically, the embolus was consisted of a tissue of anaplastic cell carcinoma, which was identical to the tumor of the resected right lung. Histological findings of other emboli of first and second case were old thrombus.

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