• Title/Summary/Keyword: Cardiac chest pain

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Clinical Evaluation and Diagnosis of Children with Chest Pain (흉부 통증을 호소한 소아에서의 임상적 고찰 및 검사)

  • Shin, Su A;Kim, Yong Joo;Lee, Jae Whan;Kim, Nam Su;Moon, Soo Ji
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1248-1252
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    • 2003
  • Purpose : Chest pain in the pediatric population is not rare and mostly benign. Causes of chest pain are diverse, and differential diagnosis is not easy. Chest pain in children is less likely to be cardiac in origin. Furthermore, chest pain in the pediatric population is rarely associated with life-threatening disease. This study was designed to evaluate children with chest pain and the usefulness of several diagnostic examinations. Methods : Between March 2001 and August 2002, 33 patients(15 boys and 18 girls, aged four to 15 years) presented with chronic chest pain. The records of these patients were reviewed. Chest radiography and electrocardiogram were performed in all patients. Cardiologic and gastrointestinal evaluations were carried out when considered necessary. Results : Chest pain was most common in the age group of 10 to 12 years old, and the four to six years old group. The most common diagnostic findings of chest pain were idiopathic(15 cases, 45.5 %), heart disease(9 cases, 27.3%), upper gastrointestinal disease(6 cases, 18.2%), respiratory disease (2 cases, 6%) and trauma(1 case, 3%). In children with abnormal results of cardiologic evaluation, these findings are not major etiologic categories of chest pain. Through history taking and physical examinations, six cases were evaluated concerning gastrointestinal disease and all of them showed gastrointestinal diseases(esophagitis, gastroesophageal reflux disease, nodular gastritis and chronic superficial gastritis). Conclusion : Chest pain is usually benign in children but the possibility of cardiovascular or gastrointestinal disease is considered. Careful history taking, physical examination and proper clinical examinations are usually required to find out the rare life-threatening causes of chest pain.

Role of Magnetocardiography in Emergency Room (응급실에서 심자도의 역할)

  • Kwon, H.;Kim, K.;Kim, J.M.;Lee, Y.H.;Kim, T.E.;Lim, H.K.;Park, Y.K.;Ko, Y.G.;Chung, N.
    • Progress in Superconductivity
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    • v.8 no.1
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    • pp.40-45
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    • 2006
  • In emergency rooms, patients with acute chest pain should be diagnosed as quickly as possible with higher diagnostic accuracy for an appropriate therapy to the patients with acute coronary syndrome or for avoiding unnecessary hospital admissions. At present, electrocardiography(ECG) and biochemical markers are generally used to detect myocardial infarction and coronary angiography is used as a gold standard to reveal the degree of narrowing of coronary artery. Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool fur the detection of cardiac electrical abnormality associated with myocardial ischemia. In this study, we examined whether the MCG can be used fur the detection of coronary artery disease(CAD) in patients, who were admitted to the emergency room with acute chest pain. MCG was recorded from 36 patients admitted to the emergency room with suspected acute coronary syndrome. The MCG recordings were obtained using a 64-channel SQUID MCG system in a magnetically shielded room. In result, presence of CAD could be found with a sensitivity of 88.2 % in patients with acute chest pain without 57 elevation in ECG, demonstrating a possible use in the emergency room to screen CAD patients.

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A Case of ECT-induced Arrhythmia(PVC) (전기경련요법에 의하여 유발된 심부정맥(PVC) 1례)

  • Kim, Duk-Ho;Lee, Ho-Taek;Paik, Ju-Hee;Lee, Sang-Yeon
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.2
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    • pp.214-217
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    • 1997
  • Electroconvulsive therapy(ECT) is one of the most effective treatment modalities for the treatment of depression, mania, schizophrenia, or other neuropsychiatric disorders. But, reportedly ECT also can produce various forms of cardiac arrhythmia. We experienced a case of ECT-induced arrhythmia(PVC) accompanied with chest pain in a schizophrenic patient during the course of plain ECT. We conclude that there is a possible causal relationship between ECT and cardiac arrhythmia(PVC). The mechanisms of cardiac arrhythmia(PVC) due to ECT may be explained by the effects of ECT to vagal and sympathetic nervous systems. from this case report, We suggest that careful cardiac monitoring before, during, and after ECT with appropriate anesthetic preparation to a patient may enable to minimize the cardiovascular side effects of ECT in the patients with neuropsychiatric disorders.

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A Study on Safe Hiking According to Caution Against Cardiac Arrest That Occurs Unexpectedly during Mountaineering (등산 중 발생하는 심정지 주의에 따른 안전산행 연구)

  • Park, Ok-Nam;OH, Hye-Ryeong
    • Proceedings of the Korean Society of Disaster Information Conference
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    • 2023.11a
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    • pp.129-130
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    • 2023
  • The From COVID-19 until recently, the demand for hiking has been rapidly increasing due to the popularization of mountain seekers.,On weekends and holidays, people who do not hike frequently while hiking in large and small mountains to see wildflowers and foliage in the mountains are more likely to be exposed to safety accidents due to an increase in sudden muscle use.,If you fall or get muscle damage during a hike, you can prevent a major accident with a simple treatment. In some cases, the error of first aid may permanently damage the important function of the body.,In particular, during a safety accident on a mountain, while climbing in light clothes, the body temperature rises due to the sweat that was shed at the beginning, and the blood pressure rises due to the contraction of the blood vessels due to the drop in body temperature from the top, resulting in an emergency such as cardiac arrest.,According to statistics from the National Park Service, nearly half (48%) of deaths in national parks are known to be sudden cardiac deaths.,There are many safety accidents that occur frequently in the mountains, but among them, we will study how to cope with acute diseases such as cardiac arrest due to increased blood pressure due to insufficient body temperature control, chest pain or dyspnea, and heart burden due to excessive hiking.

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Primary Cardiac Lipoma Combined with Chest Pain Like Angina Pectoris (협심증 증상을 동반한 심낭내 원발성 지방종)

  • Kim Jung-Tae;Oh Tae-Yoon;Chang Woon-Ha
    • Journal of Chest Surgery
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    • v.39 no.4 s.261
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    • pp.320-322
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    • 2006
  • A 60-year-old male was admitted because of dyspnea and angina like chest pain. Noninvasive findings showed a mass at the posterior aspect of the left atrium. The mass was removed under cardiopulmonary bypass. An encapsulated adipose mass, which originated from the left atrium without any invasion to the pericardium, was completely excised. Histological examination showed mature adipose tissue with partial necrosis, confirming the diagnosis of lipoma. We report a rare of case of massive left atrial lipoma occupying the pericardial space.

Changes in Respiratory & Circulatory Physiology Caused by Various Degrees of Spontaneous Pneumothorax (자연 기흉의 정도에 따른 호흡 및 순환 생리의 변화에 관한 고찰)

  • Kim, Yeong-Dae;Jeong, Hwang-Gyu
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.770-778
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    • 1994
  • Here analized the chest physiologic changes caused by various degrees of spontaneous pneumothorax in 77 patients admitted in Pusan National University Hospital from Jan. 1991 to Aug.1992. The results were summarized as follow: 1. There were 59 patients of primary spontaneous pneumothorax and 18 of secondary spontaneous pneumothorax. 2. The intrapleural pressure risings were paralled to the increasing sizes of pneumothorax, especiallythe intrapleural pressure changes were significant in large pneumothorax. In the secondary spontaneous pneumothoraces the intrapleural pressure were relatively higher than primary in the same sizes of pneumothorax. 3. The intensity of chest pain was paralled to the increasing sizes and intrapleural pressures of the pneumothorax, but the degrees of dyspnea had no linear interrelationship. 4. The pulse rate, cardiac output, and arterial PO2 started to change from positive intrapleural pressure, and significant changes were noted between 6 to 9 mmHg of intrapleural pressure. But the arterial PCO2 changes had no interrelationship to the degrees of pneumothorax.

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Intracardiac Foreign Body: A Sewing Needle in Right Ventricle of Unknown Etiology (심장내 이물질: 선행 원인이 불분명한 환자에서 발견된 우심실내 봉합침)

  • Kim, Kyung-Hwan;Chang, Ji-Min;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.33 no.8
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    • pp.681-683
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    • 2000
  • A 34 year-old woman was hospitalized with anterior chest pain and indigestion. Chest radiograph and computed tomogram revealed a sewing needle in the cardiac cavity. She had no histories of surgical intervention, drug abuse, or acupuncture. We removed the needle from the right ventricle under cardiopulmonary bypass.

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A Survey on the Delay Time Before Seeking Treatment and Clinical Symptoms in Patients with Acute Myocardial Infarction (급성 심근경색증환자의 임상적 증상과 치료추구시간의 지연)

  • 박오장;김조자;이향련;이해옥
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.659-669
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    • 2000
  • Many patients of acute myocardial infarction showed delay time before seeking treatment although they needed immediate thrombolytic therapy once they perceived their symptoms. The objectives of this study were to identify the relationship between clinical symptoms and the delay, and to find the time spent before seeking the treatment. This study was a retrospective research. The delay time for the treatment consisted of the length of delay from symptom onset to patients' decision (T1), from patients' decision making to finding transportation (T2), and from taking transportation to the first hospital arrival(T3). The subjects were 89 patients who were admitted in the ICU and Cardiac Ward at Chonnam University Hospital with the first attack of acute myocardial infarction. Center, USA The data was collected for three months from March 1st to May 31st of 1998 through questionnaires and reviewing patients' charts: The chart information was suppled by two nurses working at the ICU and Cardiac Ward. The data was analyzed by using frequency, mean and ANOVA through the SAS program. The results of study summarized as follows: 1. Sixty two patients (69.7%) were male and twenty seven patients (30.3%) were female, the ratio of male to female was 2.3 : 1. 2. In daily life, the 70.8% of the patients felt chest pain and discomfort fatigue in 67.4%, dyspnea in 57.3%, and pain in arm, neck, and jaw in 52.8%. During the attack, 97.8% of the patients felt chest pain and discomfort dyspnea in 82.1%, pain in arm, neck, jaw in 67.4% and perspiration in 51.7%. 3. The length of time a patient spent seeking time for treatment (T1+T2+T3) was 94.6 minutes, in which the time for patients' decision making for treatment (T1) was 70.3 minutes, time for finding transportation (T2) was 8.2 minutes, and time for the transportation of the patient to the first hospital (T3) was 16.1 minutes. Time for patients' decision making to go to a hospital(T1) was 74.2% of the total time sought for treatment. 4. The differences of time sought for treatment between perceptions about the seriousness of the symptoms were significant (F= 6.5, p< .01). The more serious the heart symptoms they felt, the shorter the seeking time for treatment. 5. The differences of the time delay before treatment between the degree of the symptoms were significant (F= 2.9, p< .05). The patients with the typical chest pain and discomfort spent shorter the seeking time for treatment than those with the atypical symptoms of acute myocardial infarction. 6. The differences of transportation time to the first hospital between the types of cars that the patients used, were significant (F= 4.3, p< .01). When the patients used 119 or 129 they spent the least time (5.3 minutes) for transportation, and followed by way of an ambulance (15.6 minutes), private car (20.6 minutes), and taxi (24.8 minutes).

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Neonatal Patent Ductus Arteriosus Ligation Operations Performed by Adult Cardiac Surgeons

  • Chung, Yoon Sang;Cho, Dai Yun;Kang, Hyun;Lee, Na Mi;Hong, Joonhwa
    • Journal of Chest Surgery
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    • v.50 no.4
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    • pp.242-246
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    • 2017
  • Background: Patent ductus arteriosus (PDA) ligation is usually performed by congenital cardiac surgeons. However, due to the uneven distribution of congenital cardiac surgeons in South Korea, many institutions depend solely on adult cardiac surgeons for congenital cardiac diseases. We report the outcomes of PDA ligations performed by adult cardiac surgeons at our institution. Methods: The electronic medical records of 852 neonates at Chung-Ang University Hospital, Seoul, South Korea from November 2010 to May 2014 were reviewed to identify patients with PDA. Results: Of the 111 neonates with a diagnosis of PDA, 26 (23%) underwent PDA ligation. PDAs were ligated within 28 days of birth (mean, $14.5{\pm}7.8days$), and the mean gestational age of these patients was $30.3{\pm}4.6weeks$ (range, 26 to 40 weeks) with a mean birth weight of $1,292.5{\pm}703.5g$ (range, 480 to 3,020 g). No residual shunts through the PDA were found on postoperative echocardiography. There was 1 case of 30-day mortality (3.8%) due to pneumonia, and 6 cases of in-hospital mortality (23.1%) after 30 days, which is comparable to results from other centers with congenital cardiac surgery programs. Conclusion: Although our outcomes may not be generalizable to all hospital settings without a congenital cardiac surgery program, in select centers, PDA ligations can be performed safely by adult cardiac surgeons if no congenital cardiac surgery program is available.

Bezold-Jarisch Reflex during Cervical Epidural Anesthesia -Two case reports- (경부 경막외 마취중 발생한 Bezold-Jarisch 반사 -2예 보고-)

  • Lee, Kyung-Jin;Min, Sang-Kee;Han, Sang-Gun;Lee, Sung-Jung;Kim, Myung-Eun;Moon, Bong-Kee;Lee, Young-Seok
    • The Korean Journal of Pain
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    • v.11 no.1
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    • pp.143-145
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    • 1998
  • There are reports on cervical epidural anesthesia for surgery of neck, chest and upper limb. However, there are limited published data on the specific problems with this procedure, including dural puncture, epidural abscess, and vasovagal syncopes. We experienced two cases of vasovagal syncope during cervical epidural anesthesia in the sitting position. These syncopes consisted of sudden hypotention and bradycardia, associated with nausea, dizzness and sweating. The patients were resuscitated successfully and recovered without any adverse effects. Current literature is being reviewed and the possible mechanisms of cardiac arrest under cervical epidural anesthesia in the sitting position are being discussed.

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