MyMedR

Fulltext A case report "Chest discomfort in a patient with dengue - is it an acute myocardial infarction?"

Lu HT

Malays Fam Physician, 2019;14(2):48.

PMID: 31827739

Matched MeSH terms: Chest Pain

The clinical assessment of chest pain

Lim KJ

Family Practitioner, 1983;6(2):11-14.

Matched MeSH terms: Chest Pain

Methylphenidate-associated chest pain in a child

Masiran R, Ilias MNA, Yubbu P

BMJ Case Rep, 2023 Nov 27;16(11).

PMID: 38011950 DOI: 10.1136/bcr-2023-255187

A young child was diagnosed with autism spectrum disorder with comorbid attention-deficit/hyperactivity disorder. His hyperactivity, impulsivity and absence of awareness towards danger increased his risk of harm and hence methylphenidate was indicated. Unfortunately, he developed chest pain eight months after the treatment initiation. We then stopped the stimulant and changed his treatment to atomoxetine, after which he no longer had chest pain. In the following illustrated case, we will discuss the cardiac side effect of methylphenidate.

Matched MeSH terms: Chest Pain/chemically induced; Chest Pain/drug therapy

A case of epidemic pleurodynia or Bornholm disease

HALE JH, PILLAI K

Med J Malaya, 1956 Dec;11(2):116-8.

PMID: 13417934

Matched MeSH terms: Chest Pain*

Fulltext Strangulated Morgagni hernia masquerading as an acute coronary syndrome

Ohn MH, Ng JR, Mehan TN, Luen NP

BMJ Case Rep, 2021 Jul 13;14(7).

PMID: 34257130 DOI: 10.1136/bcr-2021-244045

Morgagni hernia is the rarest type of congenital diaphragmatic hernia, which can present late in adulthood. Here, we report a case of Morgagni hernia in an elderly woman who presented as an acute coronary syndrome with raised troponin level. X-ray of the chest (CXR) showed air-fluid level in the right lower hemithorax with loss of right diaphragmatic outline and subsequently confirmed strangulated Morgagni hernia with CT. She was treated with emergency laparotomy to reduce the hernia content and surgical repair with mesh done. In conclusion, Troponin can be falsely positive in Morgagni hernia patients, possibly due to strain on the heart by herniated bowel contents. Basic imaging such as a (CXR) is useful in the case of chest pain to rule out the non-cardiac causes. Although 'time is the myocardium' in the setting of all cases of chest pain with raised troponin, CXR should be done before treatment that poses bleeding risk and unnecessary delay in laparotomy.

Matched MeSH terms: Chest Pain

An unusual cause of chest pain in army trainee - spontaneous pneumomediastinum

Lee SS

Med J Malaysia, 2016 02;71(1):30-1.

PMID: 27130742

This is a case report of spontaneous pneumomediastinum that occurred in a 19-year-old army trainee during his 2.4km run. Spontaneous pneumomediastinum is a rare disorder. It is usually precipitated by activities related to Valsalva manoeuvres such as strenuous physical activities, retching and vomiting. Treatment is expectant and the disorder usually resolves spontaneously within a few days. However, one must be aware of the disorder so that additional advice such as avoiding activities that involve Valsalva manoeuvres can be given.

Matched MeSH terms: Chest Pain/etiology*

Fulltext Solitary focal coronary artery aneurysm in a middle aged male with atypical chest pain

Yeo CK, Khalid Y

Med J Malaysia, 1999 Mar;54(1):114-6.

PMID: 10972014

A 52 year old hypertensive Malay man, a smoker who presented with a one month history of mild chest discomfort not related to exertion and had a positive stress test with ST segment depression in the lateral leads. Coronary angiography showed stenosis in the right coronary artery and a coronary aneurysm in the proximal segment of his left anterior descending. The aneurysm was situated just distal to a stenotic lesion. The aneurysm is most likely related to atherosclerotic coronary artery disease. The patient was treated with oral nitrates, aspirin, angiotensin converting enzyme inhibitor and warfarin to prevent thromboembolism related to the coronary aneurysm. He remains asymptomatic one year after diagnosis.

Matched MeSH terms: Chest Pain/etiology*

Fulltext Evaluation of the diagnostic indices and clinical utility of qualitative cardiodetect® test kit in diagnosis of ami within 12 hours of onset of chest pain in the emergency department

Hisamuddin Nar N, Suhailan M A

Int J Emerg Med, 2011;4:67.

PMID: 22032555 DOI: 10.1186/1865-1380-4-67

INTRODUCTION: Cardiac biomarkers may be invaluable in establishing the diagnosis of acute myocardial infarction (AMI) in the ED setting.
OBJECTIVE: To assess the diagnostic indices of the Cardio Detect assay and the quantitative cardiac troponin T test, in diagnosing AMI in the ED, according to the time of onset of chest pain.
METHODOLOGY: A total of 80 eligible patients presenting with ischemic type chest pain with duration of symptoms within the last 36 h were enrolled. All patients were tested for H-FABP and troponin T at presentation to the ED. A repeated Cardio Detect test was performed 1 h after the initial negative result, and a repeated troponin T test was also performed 8-12 h after an initial negative result. The diagnostic indices [sensitivity, specificity, positive predictive value, negative predictive value, receiver operating curve (ROC)] were analyzed for Cardio Detect and Troponin T (individually and in combination) and also for the repeat Cardio Detect test. Data entry and analysis were performed using SPSS version 12.0 and Analyze-it software.
RESULTS: The Cardio Detect test was more sensitive and had a higher NPV than the troponin T (TnT) test during the first 12 h of onset of chest pain. The repeat Cardio Detect had better sensitivity and NPV than the initial Cardio Detect. The sensitivity and NPV of the combination test (Cardio Detect and troponin T) were also superior to each test performed individually.
CONCLUSION: The Cardio Detect test is more sensitive and has a better NPV than the troponin T test during the first 12 h of AMI. It may be used to rule out myocardial infarction during the early phase of ischemic chest pain.

Matched MeSH terms: Chest Pain*

Fulltext Outbreak of pneumonia in an army recruit training centre, Port Dickson, Negeri Sembilan, July-August, 2000

Mohamed Paid, Y., Muhammad Amir, K., Mustafa Bakri, A., Low, S.H.

Malaysian Journal of Public Health Medicine, 2004;4(1):35-0.

MyJurnal

An outbreak of pneumonia occurred among 1,491 recruits undergoing training at the Army Recruit Training Center, Port Dickson, Negeri Sembihxn, between july to August 2000. They had reported for training 2 weeks before and were placed in new modern concrete 4 floors buiMing with well ventilated dorm. A total of 70 recruits were ajjfected and one died. The attack rate was 4.7% and the case fatality rate was 1.4%. The outbreak ajfected recruits from all the jive companies; J (21/299,
30.0%) , G (19/298, 27.1 %), I (14/298, 20.0%), H (13/298, 18.6%) and F (3/298, 4.3%) . The main presenting symptoms were fever (68/70, 97.1%), cough (62/70, 88.6%), and chest pain (35/70, 50 .0%) . This was a common site outbreak with the mode of spread from person to person through infected droplet. The outbreak has three peaks, which was at lst, 4th and 6th week respectively and lasted for eight weeks. The organisms isobted through blood culture were Streptococcal pneumoniae and Klebsiella pneumoniae. All the cases were managed and treated as in-patients at four dijjferent hospitals depending on the severity of the illness. The main control activities carried out were separation of ill recruits from the healthy, reducing the number of recruits in the dormitories and encourage recruits to drink a lot of water while in training.

Matched MeSH terms: Chest Pain

Fulltext Malignant right coronary artery in an athlete: Evidence-less based medicine?

Shariff RER, Kasim SS

Clin Med (Lond), 2020 Mar;20(2):215-216.

PMID: 32188662 DOI: 10.7861/clinmed.2019-0501

A 31-year-old man presented with central chest heaviness. He was a smoker of 15 pack-years, but otherwise had no other comorbidities. He was also a professional footballer. There was no family history of sudden cardiac deaths of note. In view of a low to intermediate pre-test probability for coronary artery disease (CAD), computed tomography coronary angiography (CTCA) was performed, revealing an anomalous, malignant right coronary artery (RCA), originating from the left main coronary stem. Malignant RCAs are rare, and the majority of patients remain asymptomatic. However, malignant RCAs have been associated with both myocardial infarctions and sudden cardiac deaths, which has led to difficulty in deciding on whether a 'watchful waiting' approach or more proactive approach should be adopted. Unfortunately, there remains a lack of evidence to help guide treatment decisions. Furthermore, there are no known guidelines on managing coronary anomalies in athletes, such as the case presented. As the majority of national guidelines have largely recommended CTCA as first-line investigation in patients with low to intermediate risk of CAD with chest pain, incidental finding of coronary anomalies will become more common, urging the need for guidelines to help with directing management in such cases.

Matched MeSH terms: Chest Pain

Fulltext Correlation between lipid profile and troponin I test results in patients with chest pain in Nepal

Kumar A, Sathian B

Asian Pac J Trop Biomed, 2013 Jun;3(6):487-91.

PMID: 23730563 DOI: 10.1016/S2221-1691(13)60101-X

To study the usefulness of traditional lipid profile levels in screening subjects who had developed chest pain due to cardiac event as indicated by a positive troponin I test.

Matched MeSH terms: Chest Pain/etiology; Chest Pain/epidemiology*

Fulltext A rare but treatable cause of recurrent chest pain - Ictal chest pain

Khoo CS, Lee D, Park KM, In Lee B, Kim SE

BMC Neurol, 2019 Dec 30;19(1):348.

PMID: 31888520 DOI: 10.1186/s12883-019-1575-0

BACKGROUND: Chest pain as the primary manifestation of epilepsy is extremely rare and has only been reported once to date.

CASE PRESENTATION: We herein describe a 47-year-old woman with recurrent chest pain for 3 years. The cause of her chest pain remained elusive despite extensive investigations including comprehensive cardiac work-up. She was referred to the neurology clinic for one episode of confusion. Video-electroencephalographic monitoring detected unequivocal ictal changes during her habitual chest pain events. She has remained chest pain (seizure) free with a single antiseizure drug.

CONCLUSIONS: This case underlines the importance of epilepsy as a rare yet treatable cause of recurrent chest pain. Further studies are required to determine the pathophysiology of ictal chest pain.

Matched MeSH terms: Chest Pain/complications*; Chest Pain/drug therapy*

Giant Cell Tumor of the Ribs and Aneurysmal Bone Cyst Presenting With Hemothorax in a Child

Alias H, Doris Lau SC, Loh CK, Ishak MI, Mohammed F, Jamal R, et al.

J Pediatr Hematol Oncol, 2017 11;39(8):e463-e465.

PMID: 28859035 DOI: 10.1097/MPH.0000000000000960

Giant cell tumor (GCT) is one of the most common tumors of bone and is the most common precursor of aneurysmal bone cysts (ABC). The clinical behavior of concurrent GCT and ABC can be very aggressive in children. GCT of the ribs, with or without ABC, is rarely seen in children. We report a case of an 8-year-old girl with GCT and associated ABC of the ribs who presented with sudden onset of chest pain and breathlessness due to a hemothorax. The patient was successfully treated by surgical resections and arterial embolization. She has remained well for 4 years after the initial surgery.

Matched MeSH terms: Chest Pain/diagnosis; Chest Pain/etiology

Fulltext Case Report: A Patient with Acute Cardiac Tamponade Secondary to Complicated Stanford Type A Intramural Haematoma - the role of CT

Poh F, Chow MB

Med J Malaysia, 2014 Feb;69(1):37-9.

PMID: 24814629

Chest pain is a common presenting complaint in the emergency room of which acute aortic syndrome is a sinister cause associated with high morbidity. A contrastenhanced CT aortogram is often performed for initial evaluation at the first instance of suspicion. We present a patient with Stanford Type A intramural haematoma complicated by haemopericardium and acute cardiac tamponade and highlight the relevant CT signs that would alert the managing physician to urgent echocardiogram correlation and emergent cardiothoracic intervention.

Matched MeSH terms: Chest Pain

Fulltext Brine shrimp lethality and acute oral toxicity studies on Swietenia mahagoni (Linn.) Jacq. seed methanolic extract

Sahgal G, Ramanathan S, Sasidharan S, Mordi MN, Ismail S, Mansor SM

Pharmacognosy Res, 2010 Jul;2(4):215-20.

PMID: 21808570 DOI: 10.4103/0974-8490.69107

The seeds of Swietenia mahagoni have been applied in folk medicine for the treatment of hypertension, diabetes, malaria, amoebiasis, cough, chest pain, and intestinal parasitism. Here we are the first to report on the toxicity of the Swietenia mahagoni crude methanolic (SMCM) seed extract.

Matched MeSH terms: Chest Pain

The utility of a 'non-significant' coronary angiogram

Wang TK, Oh TH, Samaranayake CB, Webster MW, Stewart JT, Watson T, et al.

Int J Clin Pract, 2015 Dec;69(12):1465-72.

PMID: 26304046 DOI: 10.1111/ijcp.12723

Coronary angiography is the gold standard for assessing coronary artery disease (CAD). In many patients with chest pain, no or mild CAD (< 50% stenosis) is found. It is uncertain whether this 'non-significant' result influences management and outcomes. We reviewed characteristics and outcomes in a contemporary cohort of chest pain referrals who had mild or absent CAD on coronary angiography.

Matched MeSH terms: Chest Pain

Fulltext Pleuritic chest pain and fever: An unusual presentation of aortic dissection

Mohamed-Yassin MS, Baharudin N, Ramli AS, Hashim H

Malays Fam Physician, 2019;14(1):47-52.

PMID: 31289633

It remains a challenge to diagnose aortic dissection in primary care, as classic clinical features are not always present. This case describes an atypical presentation of aortic dissection, in which the patient walked in with pleuritic central chest pain associated with a fever and elevated C-reactive protein. Classic features of tearing pain, pulse differentials, and a widened mediastinum on chest X-ray were absent. This unusual presentation highlights the need for a heightened level of clinical suspicion for aortic dissection in the absence of classic features. The case is discussed with reference to the literature on the sensitivity and specificity of the classic signs and symptoms of aortic dissection. A combination of the aortic dissection detection risk score (ADD-RS) and D-dimer test is helpful in ruling out this frequently lethal condition.

Matched MeSH terms: Chest Pain

Fulltext Diagnosing angina using a simple neural network architecture

Bulgiba, A.M.

JUMMEC, 2006;9(1):39-43.

MyJurnal

The aim of the study was to research the use of a simple neural network in diagnosing angina in patients complaining of chest pain. A total of 887 records were extracted from the electronic medical record system (EMR) in Selayang Hospital, Malaysia. Simple neural networks (simple perceptrons) were built and trained using a subset of 470 records with and without pre-processing using principal components analysis (PCA). These were subsequently tested on another subset of 417 records. Average sensitivity of 80.75% (95% CI 79.54%, 81.96%), specificity of 41.64% (95% CI 40.13%, 43.15%), PPV of 46.73% (95% CI 45.20%, 48.26%) and NPV of 77.39% (95% CI 76.11%, 78.67%) were achieved with the simple perceptron. When PCA pre-processing was used, the perceptrons had a sensitivity of 1.43% (95% CI 1.06%, 1.80%), specificity of 98.32% (95% CI 97.92%, 98.72%), PPV of 32.95% (95% CI 31.51%, 34.39%) and NPV of 61.33% (95% CI 59.84%, 62.82%). These results show that it is possible for a simple neural network to have respectable sensitivity and specificity levels for angina.

Matched MeSH terms: Chest Pain

Fulltext The ' widow maker': Electrocardiogram features that should not be missed

Yusuf Muharam M, Ahmad R, Harmy M

Malays Fam Physician, 2013;8(1):45-7.

PMID: 25606269 MyJurnal

Patients with Wellen's syndrome often present with chest pain and found to have specific precordial T-wave changes on the electrocardiogram (ECG). They subsequently develop a large anterior wall myocardial infarction. These specific electrocardiographic abnormalities are associated with critical stenosis of the proximal left anterior descending coronary artery (LAD). This syndrome is often under-recognised and has fatal consequences; it is, therefore, also known as the widow maker. We highlight a case of a 39-year old gentleman who had a history of coronary artery disease and typical ECG characteristics of Wellen's syndrome.

Matched MeSH terms: Chest Pain

Risk stratification in acute myocardial ischaemia: potential use of a rapid bedside tropinin T assay

Goh EML, Chow SK, Lang CC

JUMMEC, 2002;7:132-134.

This study is to examine the use of a Rapid Troponin T test in patients attending the Emergency Room with complaints of chest pain. The results show a strong correlation between time to positive developmentaf the Rapid Trapanin T lest to ELISA Trapanin T. These results indicate the use of a simple to perform bedside assay of Rapid Trapanin T may be used in early risk stratification of patients presenting wilh acute coronary syndromes. KEYWORDS: Rapid Trapanin T, acule coronary syndromes, risk stratification.

Matched MeSH terms: Chest Pain

Displaying publications 1 - 20 of 58 in total