Archivos de cardiología de México
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The arrival of a patient with chest pain syndrome (precordial) to the emergency represents a diagnostic challenge for the physician. Around 6 million persons are seen each year at the Emergency units in the USA. More than half of the patients are admitted for their cardiac evaluation. ⋯ We describe the algorithm used as guideline for the early diagnosis in the presence or absence of ischemic heart disease in the patient with precordial or chest pain syndrome with normal or non-diagnostic ECG at arrival to the emergency ward. It is necessary to modified the clinical educational patterns and to revaluate the advantages and limitations of the clinical history, physical exploration, as well as of the conventional ECG at rest and other diagnostic methods used specifically in relation to the chest pain syndrome with a normal or non diagnostic conventional ECG. SPECT and Gated-SPECT scintigraphy is considered as the best individual and isolated non-invasive test for the diagnostic solution of the precordial syndrome at the Emergency Unit.
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The ion channel diseases of the heart are a collection of genetically distinct arrhythmogenic cardiovascular disorders resulting from mutations in fundamental cardiac ion channels that orchestrate the action potential of the human heart. Our understanding of these genetic "channelopathies" has increased dramatically from electrocardiographic depictions of QT prolongations, ST-T alterations and torsades de pointes and clinical descriptions of people experiencing syncope and sudden death to molecular revelations of perfurbed ion channel genes. These exciting molecular breakthroughs have provided new opportunities for translational research with investigations into genotype-phenotype correlations and gene targeted therapies.