Improved Assessment of Chest pain Trial (IMPACT): assessing patients with possible acute coronary syndromes

2017 ◽  
Vol 207 (5) ◽  
pp. 195-200 ◽  
Author(s):  
Louise Cullen ◽  
Jaimi H Greenslade ◽  
Tracey Hawkins ◽  
Chris Hammett ◽  
Shanen O'Kane ◽  
...  
Keyword(s):  
Chest Pain ◽  
Acute Coronary Syndromes ◽  
Coronary Syndromes

Physical fitness cannot be used to predict the likelihood of acute coronary syndromes in ED patients with chest pain

2012 ◽  
Vol 30 (1) ◽  
pp. 57-60
Author(s):  
Taku Taira ◽  
Breena R. Taira ◽  
Jasmine Chohan ◽  
Daniel Dickinson ◽  
Regina M. Troxell ◽  
...  
Keyword(s):  
Chest Pain ◽  
Physical Fitness ◽  
Acute Coronary Syndromes ◽  
Coronary Syndromes

Chronic kidney disease as a risk factor for acute coronary syndromes in patients presenting to the emergency room with chest pain

2012 ◽  
Vol 159 (5) ◽  
pp. 391-396 ◽  
Author(s):  
Sherezade Khambatta ◽  
Michael E. Farkouh ◽  
R. Scott Wright ◽  
Guy S. Reeder ◽  
Peter A. McCullough ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Chest Pain ◽  
Kidney Disease ◽  
Emergency Room ◽  
Acute Coronary Syndromes ◽  
Coronary Syndromes

scholarly journals PRe-hospital Evaluation of Sensitive TrOponin (PRESTO) Study: multicentre prospective diagnostic accuracy study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e032834 ◽  
Author(s):  
Abdulrhman Alghamdi ◽  
Eloïse Cook ◽  
Edward Carlton ◽  
Aloysius Siriwardena ◽  
Mark Hann ◽  
...  
Keyword(s):  
Chest Pain ◽  
Hospital Admission ◽  
Diagnostic Accuracy ◽  
Blood Sample ◽  
Acute Coronary Syndromes ◽  
Venous Blood ◽  
Prehospital Setting ◽  
Registration Number ◽  
Coronary Syndromes ◽  
Rule Out

IntroductionWithin the UK, chest pain is one of the most common reasons for emergency (999) ambulance calls and the most common reason for emergency hospital admission. Diagnosing acute coronary syndromes (ACS) in a patient with chest pain in the prehospital setting by a paramedic is challenging. The Troponin-only Manchester Acute Coronary Syndromes (T-MACS) decision rule is a validated tool used in the emergency department (ED) to stratify patients with suspected ACS following a single blood test.We are seeking to evaluate the diagnostic accuracy of the T-MACS decision aid algorithm to ‘rule out’ ACS when used in the prehospital environment with point-of-care troponin assays. If successful, this could allow paramedics to immediately rule out ACS for patients in the ‘very low risk’ group and avoid the need for transport to the ED, while also risk stratifying other patients using a single blood sample taken in the prehospital setting.Methods and analysisWe will recruit patients who call emergency (999) ambulance services where the responding paramedic suspects cardiac chest pain. The data required to apply T-MACS will be prospectively recorded by paramedics who are responding to each patient. Paramedics will be required to draw a venous blood sample at the time of arrival to the patient. Blood samples will later be tested in batches for cardiac troponin, using commercially available troponin assays. The primary outcome will be a diagnosis of acute myocardial infarction, established at the time of initial hospital admission. The secondary outcomes will include any major adverse cardiac events within 30 days of enrolment.Ethics and disseminationThe study obtained approval from the National Research Ethics Service (reference: 18/ES/0101) and the Health Research Authority. We will publish our findings in a high impact general medical journal.Trial registration numberRegistration number: ClinicalTrials.gov, study ID: NCT03561051

Chest Pain and Acute Coronary Syndromes (ACS)

2003 ◽  
pp. 43-43
Author(s):  
Shashiraj E ◽  
Babu Palatty ◽  
Amiya Chakraborty
Keyword(s):  
Chest Pain ◽  
Acute Coronary Syndromes ◽  
Coronary Syndromes

scholarly journals Coronavirus disease 2019 is delaying the diagnosis and management of chest pain, acute coronary syndromes, myocarditis and heart failure

2021 ◽  
Vol 17 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Bhurint Siripanthong ◽  
Thomas C Hanff ◽  
Michael G Levin ◽  
Mahesh K Vidula ◽  
Mohammed Y Khanji ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chest Pain ◽  
Acute Coronary Syndromes ◽  
Diagnosis And Management ◽  
Coronary Syndromes

Chest pain and chest pain units

2018 ◽  
Author(s):  
Eric Durand ◽  
Aurès Chaib ◽  
Etienne Puymirat ◽  
Nicolas Danchin
Keyword(s):  
Acute Coronary Syndrome ◽  
Chest Pain ◽  
Acute Coronary Syndromes ◽  
Acute Chest Pain ◽  
The United States ◽  
Cardiac Biomarkers ◽  
Coronary Syndrome ◽  
Cardiology Department ◽  
Coronary Syndromes ◽  
Rule Out

Patients presenting at the emergency department with acute chest pain and suspected to represent an acute coronary syndrome were classically admitted as routine to the cardiology department, resulting in expensive and time-consuming evaluations. However, 2-5% of patients with acute coronary syndromes were discharged home inappropriately, resulting in increased mortality. To address the inability to exclude the diagnosis of acute coronary syndrome, chest pain units were developed, particularly in the United States. These provide an environment where serial electrocardiograms, cardiac biomarkers, and provocative testing can be performed to confirm or rule out an acute coronary syndrome. Eligible candidates include the majority of patients with non-diagnostic electrocardiograms. The results have been impressive; chest pain units have markedly reduced adverse events, while simultaneously increasing the rate of safe discharge by 36%. Despite evidence to suggest that care in chest pain units is more effective for such patients, the percentage of emergency or cardiology departments setting up chest pain units remains low in Europe.

Use of Excimer Laser for Thrombus Containing Lesion

2003 ◽  
Vol 11 (3) ◽  
pp. 269-271 ◽  
Author(s):  
Erdogan Ilkay ◽  
Ilgin Karaca ◽  
Mustafa Yavuzkir ◽  
Özlem Gündoğdu ◽  
Nadi Arslan
Keyword(s):  
Chest Pain ◽  
Coronary Artery ◽  
Acute Coronary Syndromes ◽  
Laser Application ◽  
Coronary Syndromes ◽  
Receptor Blockers ◽  
The Right ◽  
Distal Vessel ◽  
Mechanical Intervention ◽  
Grade Iii

The presence of thrombus in the lesion before balloon angioplasty increases the complications arising from mechanical intervention. It is known that the use of Gp llb/llla receptor blockers before the intervention enhances the reliability of the procedure. Laser thrombolysis was applied to a patient who underwent coronary angiography due to recurrent chest pain after thirty six hour administration of tirofiban and who was found to have a thrombus so large as to block the distal vessel bed of the right coronary artery. Following the procedure, the entire thrombus was broken down and Grade III distal myocardial perfusion was achieved. This case is important in demonstrating that laser application is a viable alternative in such instances, especially considering that intervention in acute coronary syndromes is on the increase and cardiologists will frequently encounter such cases.

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