Relief of myocardial ischemia pain with a gastrointestinal cocktail

Servi, Ronald J.; Skiendzielewski, John J.

doi:10.1016/0735-6757(85)90091-9

Cited by 13 publications

(5 citation statements)

References 6 publications

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“…52 However, more recent studies and case series have contradicted these findings. 53,54 Rest. Rest characteristically relieves the pain associated with stable angina within 1 to 5 minutes.…”

Section: Relieving Factorsmentioning

confidence: 99%

Value and Limitations of Chest Pain History in the Evaluation of Patients With Suspected Acute Coronary Syndromes

Swap

Nagurney²

2005

JAMA

359

194

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Context The chest pain history, physical examination, determination of coronary artery disease (CAD) risk factors, and the initial electrocardiogram compose the information immediately available to clinicians to help determine the probability of acute myocardial infarction (AMI) or acute coronary syndrome (ACS) in patients with chest pain. However, conflicting data exist about the usefulness of the chest pain history and which components are most useful. Objective To identify the elements of the chest pain history that may be most helpful to the clinician in identifying ACS in patients presenting with chest pain. Evidence Acquisition MEDLINE and Ovid were searched from 1970 to September 2005 by using specific key words and Medical Subject Heading terms. Reference lists of these articles and current cardiology textbooks were also consulted. Evidence Synthesis Certain chest pain characteristics decrease the likelihood of ACS or AMI, namely, pain that is stabbing, pleuritic, positional, or reproducible by palpation (likelihood ratios [LRs] 0.2-0.3). Conversely, chest pain that radiates to one shoulder or both shoulders or arms or is precipitated by exertion is associated with LRs (2.3-4.7) that increase the likelihood of ACS. The chest pain history itself has not proven to be a powerful enough predictive tool to obviate the need for at least some diagnostic testing. Combinations of elements of the chest pain history with other initially available information, such as a history of CAD, have identified certain groups that may be safe for discharge without further evaluation, but further study is needed before such a recommendation can be considered reasonable. Conclusion Although certain elements of the chest pain history are associated with increased or decreased likelihoods of a diagnosis of ACS or AMI, none of them alone or in combination identify a group of patients that can be safely discharged without further diagnostic testing.

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Section: Relieving Factorsmentioning

confidence: 99%

Value and Limitations of Chest Pain History in the Evaluation of Patients With Suspected Acute Coronary Syndromes

Swap

Nagurney²

2005

JAMA

359

194

View full text Add to dashboard Cite

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“…Gastrointestinal distress, dyspnea, or syncope may be the predominant symptoms of AMI [9,12,13,33]. Although atypical symptoms of palpitations, tingling, and numbness in the arms and hands are more likely to occur in patients with noncardiac conditions [35], their presence cannot diminish the suspicion of CHD in the patient with risk factors.…”

Section: Differential Diagnosismentioning

confidence: 97%

“…Gastrointestinal cocktails, consisting of an antacid, an anticholinergic, and viscous xylocaine, have been shown in recent reports to successfully relieve myocardial ischemic pain [33]. One study of 82 admissions to a CCU [10] found that 40% (N = 28) of patients with myocardial ischemia experienced some degree of indigestion.…”

Section: Differential Diagnosismentioning

confidence: 99%

A Review of Atypical Clinical Manifestations of Acute Myocardial Infarction

Neill

1987

J Intensive Care Med

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Neill KM. A review of atypical clinical manifestations of acute myocardial infarction. J Intensive Care Med 1987;2:25-32.This review describes pertinent demographic and illness characteristics of patients who are seen with atypical symptoms of acute myocardial infarction. The determination of psychosocial, behavioral, and environmental patterns of patients complaining of chest discomfort adds important information to the clinical assessment of chest pain. Systematic information about the pain and other symptoms of acute myocardial infarction and about the variables that influence these symptoms can assist practitioners as well as sufferers of myocardial pain to resolve the uncertainty surrounding it.From the Address reprint requests to Dr Neill.Despite recent dramatic declines in coronary mortality, coronary heart disease (CHD) remains the primary cause of death in the United States. The main symptom of CHD is chest pain masked in many forms and minimized by many victims. Of the estimated 1.5 million Americans who will have a myocardial infarction in 1987, over one-third will die that same year. Of those who die of acute myocardial infarction (AMI), 62% never reach the hospital. The average victim waits three hours before seeking assistance [1]. This review includes discussions of studies of clues and disguises of AMI. A better understanding of the early clues of AMI could result in faster recognition of myocardial pain by the victim. Earlier recognition by the victim could lead to less delay in seeking treatment, less myocardial ischemic damage, and, consequently, fewer deaths from coronary heart disease.In an attempt to reduce health care costs by decreasing the number of unnecessary admissions to coronary care units (CCUs) and identifying appropriate candidates for early discharge, efforts are being made to increase the reliability of diagnoses regarding myocardial pain [2][3][4]. Understanding the significance of chest pain is as difficult for the clinician as it is for the patient [5]. In one six-month survey of 588 patients admitted to an emergency room for chest pain, 85 different diagnoses were obtained [6].To make a quick and accurate clinical diagnosis of myocardial infarction or ischemia, medical personnel have been increasingly more reliant on laboratory data and electrocardiograms (ECGs). Reliance on technical data for diagnosis of AMI, however, is not without its problems. In a retrospective study of 100 autopsy-proved acute myocardial infarctions, 47% were not diagnosed [7]. This failure rate had not improved on that of studies conducted several decades ago. The physician-

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“…23 Lo mismo sucede con la respuesta a los cocteles para problemas gastrointestinales. 24 Después de varios minutos en reposo, el alivio del dolor, aunque útil para la angina estable crónica, no es de ayuda para descartar el problema coronario agudo. 25 Fatih Aydin y su equipo de Turquía desarrollaron en 2019 una puntuación basada sólo en el dolor torácico, sin otros aspectos, en 484 pacientes con dolor de pecho.…”

Section: Aspectos Clínicosunclassified