Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
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Review Case Reports
"Mass-ive" infarction: case report and review of myocardial metastatic malignancies.
Metastatic cancers to the heart are uncommon but occur up to 20 to 40 times more frequently than primary tumors of the heart. Cardiac metastases from lung cancer are rarely diagnosed ante mortem and usually cause no symptoms or signs. In this case report cardiac metastasis from a primary adenosquamous cancer of the lung presented as myocardial infarction in a 61-year-old man. His diagnosis was made and confirmed via multimodality imaging of the heart, which is also reviewed in depth.
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Review Meta Analysis
Acute chest pain imaging in the emergency department with cardiac computed tomography angiography.
In practice, the determination of ischemic chest pain in the emergency department (ED) population is difficult and errors are common. Cardiac computed tomography angiography has recently emerged for accurate noninvasive evaluation of coronary artery disease, and it may offer a promising new approach to improve the triage of patients presenting to the ED with acute chest pain, in particular in terms of a faster and accurate way to determine the diagnosis, which could effectively reduce hospital admissions and costs. The focus of this article is to review the current literature on the use of cardiac computed tomography angiography in the ED setting by providing pooled sensitivity, specificity, and positive and negative predictive values of the published literature to date. Moreover, different protocols for detection of patients with cardiac and other, noncardiac causes of chest pain (triple rule-out protocol) are discussed.
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Chest pain is one of the most common complaints of patients presenting at emergency departments. However, the most appropriate diagnostic evaluation for patients with chest pain but without acute coronary syndrome remains controversial, and differs greatly among institutions and physicians. At our institution, patients with chest pain can be admitted to an internist-run hospitalist service, a private attending service, or a cardiologist-run Chest Pain Unit. The goal of the present study was to compare the management and outcomes of patients admitted with chest pain based on admitting service. ⋯ The results of this study demonstrate that a highly protocolized chest pain unit, using myocardial perfusion imaging as primary diagnostic modality, results in a decreased length of stay and readmission rate.