Segmental Thoracic Pain in Patients Admitted to a Medical Department and a Coronary Unit

Bechgaard, P

doi:10.1111/j.0954-6820.1981.tb03131.x

Cited by 17 publications

(3 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It may be improved by antacids. Musculoskeletal pain may also be precipitated by exercise but usually involving the arms,70 back or the affected joint. The pain from carpal tunnel syndrome sometimes radiates to the left side of the chest.…”

Section: Managing the Patient With Nccpmentioning

confidence: 99%

The head says yes but the heart says no: what is non-cardiac chest pain and how is it managed?

Chambers

Marks

Hunter

2015

Heart

View full text Add to dashboard Cite

Section: Managing the Patient With Nccpmentioning

confidence: 99%

The head says yes but the heart says no: what is non-cardiac chest pain and how is it managed?

Chambers

Marks

Hunter

2015

Heart

View full text Add to dashboard Cite

“…Angina‐like pain might be caused by several aetiologies and many recent studies have dealt with patients diagnosed as having angina pectoris with minimally or non‐obstructive arteries by coronary arteriography 139–150 . The ‘non‐cardiac’ causes of chest pain include abnormal oesophageal function and acid reflux, 151–173 chest wall and musculoskeletal pain 174–176 . hyperventilatory and aerophagic chest pain 177–187 and cardiopathia fantastica.…”

Section: Symptoms and Signsmentioning

confidence: 99%

Histamine‐induced Coronary Artery Spasm: The Concept of Allergic Angina

Kounis¹,

Zavras²

1991

Int J Clinical Practice

386

View full text Add to dashboard Cite

SUMMARYHistamine, the main amine released during allergic reactions, can provoke coronary arterial spasm manifested as angina pectoris. This has been shown during clinical and laboratory studies. The effects of histamine on cardiac function are mediated via H1‐ and H2‐ receptors situated on the four cardiac chambers and coronary arteries. Coronary arteries of cardiac patients are hyperactive and contain stores of histamine which can initiate coronary artery spasm.Clinical observations indicate that angina pectoris or acute myocardial infarction can be provoked by acute allergic reaction. The coincidental occurrence of chest pain and allergic reaction accompanied by clinical and laboratory findings of classical angina pectoris seems to constitute the syndrome of allergic angina. The clinical symptoms of allergic angina include chest discomfort, dyspnoea, faintness, nausea, pruritus and urticaria. They are accompanied by signs such as hypotension, diaphoresis, pallor and bradycardia. There are also electrocardiographic findings indicating myocardial ischaemia, arrhythmias and conduction defects.Thus, in patients undergoing acute allergic reaction, the development of chest pain could be explained by the mechanism of coronary arterial spasm provoked by the release of histamine, which constitutes the syndrome of allergic angina.

show abstract

“…Acute chest pain is believed to be one of the most common reasons for hospital admission in Denmark [ 1 , 2 ]. Figures from the United States show that chest pain is the second most common reason for emergency department visits, accounting for 5.4% or more than 4 million visits per year [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnosis and treatment of musculoskeletal chest pain: design of a multi-purpose trial

Stochkendahl

Christensen

Vach

et al. 2008

BMC Musculoskelet Disord

View full text Add to dashboard Cite

BackgroundAcute chest pain is a major health problem all over the western world. Active approaches are directed towards diagnosis and treatment of potentially life threatening conditions, especially acute coronary syndrome/ischemic heart disease. However, according to the literature, chest pain may also be due to a variety of extra-cardiac disorders including dysfunction of muscles and joints of the chest wall or the cervical and thoracic part of the spine. The diagnostic approaches and treatment options for this group of patients are scarce and formal clinical studies addressing the effect of various treatments are lacking.Methods/DesignWe present an ongoing trial on the potential usefulness of chiropractic diagnosis and treatment in patients dismissed from an acute chest pain clinic without a diagnosis of acute coronary syndrome. The aims are to determine the proportion of patients in whom chest pain may be of musculoskeletal rather than cardiac origin and to investigate the decision process of a chiropractor in diagnosing these patients; further, to examine whether chiropractic treatment can reduce pain and improve physical function when compared to advice directed towards promoting self-management, and, finally, to estimate the cost-effectiveness of these procedures. This study will include 300 patients discharged from a university hospital acute chest pain clinic without a diagnosis of acute coronary syndrome or any other obvious cardiac or non-cardiac disease. After completion of the clinic's standard cardiovascular diagnostic procedures, trial patients will be examined according to a standardized protocol including a) a self-report questionnaire; b) a semi-structured interview; c) a general health examination; and d) a specific manual examination of the muscles and joints of the neck, thoracic spine, and thorax in order to determine whether the pain is likely to be of musculoskeletal origin. To describe the patients status with regards to ischemic heart disease, and to compare and indirectly validate the musculoskeletal diagnosis, myocardial perfusion scintigraphy is performed in all patients 2–4 weeks following discharge. Descriptive statistics including parametric and non-parametric methods will be applied in order to compare patients with and without musculoskeletal chest pain in relation to their scintigraphic findings. The decision making process of the chiropractor will be elucidated and reconstructed using the CART method. Out of the 300 patients 120 intended patients with suspected musculoskeletal chest pain will be randomized into one of two groups: a) a course of chiropractic treatment (therapy group) of up to ten treatment sessions focusing on high velocity, low amplitude manipulation of the cervical and thoracic spine, mobilisation, and soft tissue techniques. b) Advice promoting self-management and individual instructions focusing on posture and muscle stretch (advice group). Outcome measures are pain, physical function, overall health, self-perceived treatment effect, and cost-effectiveness.D...

show abstract

Segmental Thoracic Pain in Patients Admitted to a Medical Department and a Coronary Unit

Cited by 17 publications

References 4 publications

The head says yes but the heart says no: what is non-cardiac chest pain and how is it managed?

The head says yes but the heart says no: what is non-cardiac chest pain and how is it managed?

Histamine‐induced Coronary Artery Spasm: The Concept of Allergic Angina

Diagnosis and treatment of musculoskeletal chest pain: design of a multi-purpose trial

Contact Info

Product

Resources

About