• Title/Summary/Keyword: chest pain(胸痛)

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Impact of Depression and Anxiety on Quality of Life in Patients with Chest Pain (우울과 불안이 흉통 환자의 삶의 질에 미치는 영향)

  • Shin, Mi Hee;Park, Sook Hyun;Lee, Han Cheol;Moon, Eunsoo;Lee, Hye-Won;Kim, Bo Won
    • Anxiety and mood
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    • v.7 no.2
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    • pp.79-84
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    • 2011
  • Objectives : There has been substantial evidence that patients with chest pain have depression and anxiety, and show impaired quality of life (QoL). This study aimed to campare the QoL according to types of chest pain and to examine the impact of depression and anxiety on QoL in patients with chest pain. Methods : Forty-seven patients with chest pain were divided into Cardiac-Typical Chest Pain (CTCP, n=22) and Non-Cardiac-Atypical Chest Pain groups (NCACP, n=25) according to the pain characteristics and cardiovascular disease. Patients were assessed for depression using the Beck Depression Inventory (BDI), for anxiety using the State-Trait Anxiety Inventory (STAI), and QoL was assessed using the Korean version of the SmithKlein Beecham 'Quality of Life' Scale (KvSBQOL). Results : Compared with the CTCP group, the NCACP group reported significantly higher anxiety, and lower QoL. There was no significant difference in QoL between the two groups after adjusting for anxiety. The QoL was associated with depression and trait-anxiety in the CTCP group, and with trait-anxiety in the NCACP group. Conclusion : The findings suggest that there are different effects of depression and anxiety on QoL in individuals with CTCP and NCACP. Understanding about these differences can be important in the treatment of patients with chest pain. A large prospective study is needed to confirm these results.

Septic Arthritis of the Manubriosternal Joint in an Adolescent: A Case Report

  • Soongang Park;Joon Kee Lee
    • Pediatric Infection and Vaccine
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    • v.31 no.1
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    • pp.153-157
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    • 2024
  • Septic arthritis of the manubriosternal joint is a rare condition, especially in adolescents, who often present with nonspecific symptoms that can mimic more common conditions such as musculoskeletal chest pain, costochondritis. Here, we report a case of septic arthritis in a 17-year-old girl and highlight the challenges in diagnosing and managing this condition in adolescents. Initially presenting with acute chest pain diagnosed as transient nonspecific chest pain, the patient's subsequent visits to the emergency department unveiled escalating symptoms, including high fever, prompting advanced imaging. Ultimately, the diagnosis of septic arthritis of the manubriosternal joint was confirmed, with blood culture growth revealing Methicillin-sensitive Staphylococcus aureus. Diagnostic delays have been attributed to the absence of typical symptoms and patient reluctance to be hospitalized. Our case emphasizes the importance of considering rare infectious etiologies in adolescents with chest pain and emphasizes the need for heightened suspicion in unusual anatomical sites. Further research is required to elucidate the pathogenesis and risk factors associated with this condition to aid in prompt diagnosis and treatment.

A Case of Treating Chest Pain Associated with Myocardial Bridge (흉통(胸痛)이 있는 심근교(myocardial bridge) 환자의 치험 1례)

  • Kim, Bo-ram;Choi, Dong-jun;Lim, Sung-woo
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.74-80
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    • 2009
  • Myocardial bridging, a congenital coronary anomaly, is present when a segment of a major epicardial coronary artery, runs intramurally through the myocardium. So with each systole, the coronary artery is compressed. It has been associated with angina, arrhythmia, myocardial infarction and sudden cardiac death. This is a case of a 39-year-old woman who was diagnosed myocardial bridge. She complained of recurrent chest pain, palpitation. We diagnosed her as Gyesimtong(JiXiTong, 悸心痛), and prescribed Jeongkicheonhyang-tang(正氣天香湯). After treatment, all of the symptoms had improved and have not recurred for 18 months. This case suggests that oriental medicine therapy can be applicable to improve in symptoms of myocardial bridge.

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Korean Medicine Treatment for Chronic Atypical Chest Pain Diagnosed as Coronary Artery Disease: A Case Report (관상동맥질환으로 진단된 만성 비정형 흉통의 한의진료 경과 : 증례보고)

  • Kim, Eunmi;Jo, Hee-Geun
    • The Journal of Internal Korean Medicine
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    • v.41 no.4
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    • pp.688-698
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    • 2020
  • Background: The aim of this study was to determine the overall effects and the clinical effect of Korean medicine treatment on chronic atypical chest pain. Case Report: A 56-year-old male patient suffering from chronic atypical chest pain was treated with herbal medicine and acupuncture. We used the Baseline Dyspnea Index (BDI), Pittsburgh Sleep Quality Index (PSQI), and a verbal numerical rating score (VNRS) to assess the patient's symptoms. The administration of the new herbal medicine and local acupuncture point stimulation improved the chest pain and dyspnea symptoms. No side effects were observed during the treatment. Conclusions: The study findings suggest that Korean medicine treatments, such as herbal medicine and local acupuncture point stimulation, may be effective as treatments for atypical chest pain and secondary symptoms in patients with coronary artery disease.

Clinical Presentation of the Patients with Non-traumatic Chest Pain in Emergency Department (응급의료센터에 내원한 비외상성 흉통환자의 임상 양상)

  • Chung, Jun-Young;Lee, Sam-Beom;Do, Byung-Soo;Park, Jong-Seon;Shin, Dong-Gu;Kim, Young-Jo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.283-295
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    • 1999
  • Background: Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were $1.1{\pm}0.9$ in non-cardiac diseases, $1.4{\pm}1.1$ in cardiac diseases and $1.7{\pm}1.1$ in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. Conclusion: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

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Comparison of Health Behaviors and Health Indices According to Percutaneous Coronary Intervention in Patients with Chest Pain -Analysis of Nursing Information Chart and Electronic Medical Record- (흉통환자의 관상동맥중재술 시행 여부에 따른 건강행위 및 건강지표 비교 - 간호정보조사지와 전자의무기록 분석-)

  • Kweon, Mi-Soo;Lee, Sook-Jeong
    • The Journal of the Korea Contents Association
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    • v.19 no.12
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    • pp.279-288
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    • 2019
  • The purpose of this study was to compare the health behaviors and health indices according to whether a percutaneous coronary intervention(PCI) was performed due to chest pain. This is a secondary data analysis study of nursing information questionnaires and electronic medical records of 247 chest pain patients in a hospital from January 2010 to December 2017. The participants were divided into non-PCI and PCI groups, and the health behaviors, blood pressure, and blood lipid levels were collected at the first hospital admission and re-admission. Collected data were analyzed using SPSS 24.0. As a result of the study, smoking and lipid levels were significantly healthier than the participants in PCI group during re-hospitalization. Non-PCI group had a high risk of smoking despite the high risk of coronary artery stenosis. It was found that continuous integrated management to promote health behavior is needed. The significance of this study was to identify the importance of health behavior in patients with the risk of cardiovascular disease.

Case Report of Korean Medical Treatment of Chest Pain After Percutaneous Coronary Intervention (경피적관상동맥중재술을 시행한 후 발생한 흉통(胸痛)에 대한 한방치료 1례)

  • Min, Seon-woo;Kim, Hak-kyeom;Moon, Ji-seong;Kim, Ye-seul;Park, Ji-yoon;Jeong, Ji-cheon
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.184-196
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    • 2021
  • Objectives: This case report presents the effects of Korean medical treatment in a patient with chest pain after percutaneous coronary intervention (PCI). Methods: An 80-year-old woman was treated with Korean herbal medicine, acupuncture, and cupping therapy. Chest pain, sore tongue, and headache were assessed daily using a numeric rating scale (NRS). Results: After 15 days of treatment, chest pain disappeared, as reflected by an NRS change from 9 to 0, and headache was relieved (NRS decreased from 9 to 2). On the eighth day of treatment, the sore tongue was also relieved, as reflected by an NRS change from 9 to 0. Conclusion: These results show that chest pain after PCI can be relieved with Korean medical treatment, and it is expected that major adverse cardiac events (MACEs) may be prevented with Korean medical treatment. However, additional well-designed studies are required to confirm these findings.

A study on characteristics and physiological variables of chest pain induced by exercise test in angina suspected patients (협심증이 의심되는 환자에서 운동부하검사로 유발되는 흉통의 양상과 생리적 변인에 관한 연구)

  • Cho, Mi-Kyoung;Choe, Myoung-Ae
    • Journal of Korean Biological Nursing Science
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    • v.2 no.2
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    • pp.1-19
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    • 2000
  • The purpose of this study was to identify the characteristics and physiological variables of chest pain induced by exercise test in angina suspected patients. The subjects of this study consisted of 28 inpatients and outpatients aged between 40 and 75 who underwent treadmill test at exercise testing laboratory of S-University from January 2000 to June 2000. Subjects were interviewed with questionnaire regarding sociodemography, the past health history and history related to chest pain before the exercise test. Subjects were interviewed with questionnaire concerning quality, intensity, duration of chest pain induced by walking on the treadmill(Marquette, U.S.A. 1992) according to Bruce protocol following exercise test. Systolic and diastolic blood pressure were measured before, during and after the test, heart rate was determined by ECG. The results of this study were as follows ; 1) Quality of chest pain induced by exercise test were feeling stiffness 19(67.9%), heavy 10(36.0%), exploded 9(32.1%), crushing, suffocating, tight 8(28.6%), stuffy, prickly 7(25.0%), burning 6(21.4%), clasp 5(17.9%), cleaved, tensed, piercing 3(10.7%), perfectly fitting, sore 2(7.1%), tearing, tingling, ticklish, heartburn 1(3.6%). 2) Mean score of VAS(intensity of pain) following exercise test was $5.79{\pm}2.27$ and mean duration of chest pain after the test was $7.83{\pm}5.31$ minutes. 3) Sites of chest-pain induced by exercise test were middle site 11(39.3%), left-chest 10(35.6%), right-chest 6(21.5%). Radiation site of chest-pain was neck(18.0%), right flank site 1(3.6%), left shoulder & arm 2(7.1%) and back 1(3.6%). 4) Symptoms other than chest-pain induced by exercise test were dyspnea 21(75.6%), perspiration 14(50.4%), fatigue 12(43.2%), leg-pain 11(39.6%), dizziness 7(25.2%) anxiety toward chest-pain 3(10.8%), thirst 2(7.1%), and palpation, headache and tingling sensation of hand and leg 1(3.6%). 5) Mean MET(intensity of exercise) during the exercise test was $7.64{\pm}2.57$ and mean RPE(rating of perceived exertion) was $15.89{\pm}2.36$. Mean duration of exercise was $6.79{\pm}2.88$. 6) correlation coefficients between RPE and VAS was 0.500(p=0.003), those between MET and VAS was 0.287(p=0.069) and those between either depression or elevation of ST segment and VAS was 0.236(p=0.114). 7) There was a significant difference in mean systolic pressure between before and after the test as $146.29{\pm}28.18mmHg$ and $177.96{\pm}28.82mmHg$(t=-5.640, p=0.000), a significant difference in mean diastolic blood pressure between before and after the test as $84.85{\pm}15.07mmHg$ and $88.89{\pm}13.72mmHg$(t=-2.082, p=0.047), and there was a significant difference in mean heart-rate between before and after the test as $81.89{\pm}12.22/min$ and $160.68{\pm}21.77/min$(t=-21.255, p=0.000).

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Utility of the Dispatch Protocol to Triage the Emergency Patients who presented with Symptoms of Stroke or Chest Pain (흉통 및 뇌졸중 증상 환자에 대한 전화 중증도분류 지침의 유용성)

  • Cho, Suck-Ju;An, Byeung-Ki;Park, Jae-Yong
    • The Journal of the Korea Contents Association
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    • v.12 no.12
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    • pp.345-355
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    • 2012
  • Delayed treatment of acute cardiovascular and cereb-directrovascular diseases is related to poor prognosis and sequelae. For rapid and adequate treatment, role of prehospital emergency dispatchers for adequate triage and selection of hospital is important. In several advanced countries, emergency dispatchers use standardized protocols for decision of rescuer resources or distribution of patients at each hospital. ut, there has not been developed standardized protocol for emergency dispatchers in Korea. We developed standardized protocol based on NHS-direct and CTAS system for triage of symptoms of chest pain and Stroke. Groups with standardized protocol and without protocol was compared to triage result at emergency department which patient visited. The accuracy of triage on chest pain was 70.0% in group A, 94.0% in group B(p<0.01). The accuracy of triage in stroke symptoms was 64.2% in group A, 84.6% in group B(p<0.01). Conclusion: In this study, the accuracy of telephone triage with the protocol was more accurate than without the protocol. But, more studies are needed to generalize the protocol in South korea.

Back and Chest Pain Related to Scalenus Medius Muscle (중사각근과 관련된 배부통과 흉통에 관한 연구)

  • Choe, Joong-Rieb
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.63-68
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    • 1992
  • One hundred and four patients who complained of chest pain or back pain in the region between scapular were studied. In most cases, anatomical location of pain was in the rhomboid or serratus anterior muscle. Hyperactivity of dorsal scapular nerve or long thoracic nerve which innervate those muscles was thought to be responsible for the pain. The hyperactivity of the nerves may be due to the spasm of the scalenus medius muscle which the nerves meet during their course to the rhomboid or serratus anterior muscles. Therefore, spasmolytic treatment including trigger point injection, physical therapy, laser therapy, or NSAIDs may be effective for the treatment of chest pain or back pain.

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