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A 70-something female with no previous cardiac history presented with acute chestpain. She awoke from sleep last night around 4:45 AM (3 hours prior to arrival) with pain that originated in her mid back. She stated the pain was achy/crampy. Over the course of the next hour, this pain turned into a pressure in her chest.
CT coronary angiography, in addition to a CT CAC, is arguably the best test for estimating whether someone has evidence of coronaryarterydisease and what that means for their near-term risk of a heart attack. This article is part 2 of a series on cardiac CT. I would say yes. For very good reason. And it matters.
A 34 yo woman with a history of HTN, h/o SVT s/p ablation 2006, and 5 months post-partum presented with intermittent central chestpain and SOB. She had one episode of pain the previous night and two additional episodes early on morning the morning she presented. Deep breaths are painful and symptoms come and go.
The key issue when it comes to the near-term risk of a heart attack is whether you already have coronaryarterydisease and how much of it. We look directly at the coronaryarteries using a cardiac CT scan. When I say the near term, I am talking about 5 to 10 years. When I say long-term, I mean 50 years.
A 30-something male presented in the middle of the night with several hours of sharp, non-radiating, left sided chestpain. No angiographically significant obstructive coronaryarterydisease. CT coronaryangiogram is excellent , but is rarely available outside of business hours, and hardly ever at night.
Knowledge of this fundamental pillar of biology should drive how cardiologists approach men and women being evaluated for the presence of significant coronarydisease. Atypical angina is classified as having any two of the three symptoms, and non-anginal pain any one of the three symptoms. versus 66.3%; P =0.004), older age (62.4±7.9
He has never had any chestpain. He has no known prior medical history and does not take any medications. He complains of occasional shortness of breath on walking more than 2 blocks. He has never smoked and denies any alcohol or drug abuse history. He was adopted and does not know anything about his parents or siblings.
The best course is to wait until the anatomy is defined by angio, then if proceeding to PCI, add Cangrelor (an IV P2Y12 inhibitor) I sent the ECG and clinical information of a 90-year old with chestpain to Dr. McLaren. Incidence of an acute coronary occlusion. His response: “subendocardial ischemia.
It was edited by Smith CASE : A 52-year-old male with a past medical history of hypertension and COPD summoned EMS with complaints of chestpain, weakness and nausea. The diagnostic coronaryangiogram identified only minimal coronaryarterydisease, but there was a severely calcified, ‘immobile’ aortic valve.
A 69 year old woman with a history of hypertension presented to the emergency department by EMS for evaluation of chestpain and shortness of breath. She awoke in the morning with sharp chestpain which worsened throughout the morning. As her pain worsened, so did her dyspnea. This was written by Hans Helseth.
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