• Anxiety and mood
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• v.7 no.2
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• pp.79-84
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• 2011

Objectives : There has been substantial evidence that patients with chest pain have depression and anxiety, and show impaired quality of life (QoL). This study aimed to campare the QoL according to types of chest pain and to examine the impact of depression and anxiety on QoL in patients with chest pain. Methods : Forty-seven patients with chest pain were divided into Cardiac-Typical Chest Pain (CTCP, n=22) and Non-Cardiac-Atypical Chest Pain groups (NCACP, n=25) according to the pain characteristics and cardiovascular disease. Patients were assessed for depression using the Beck Depression Inventory (BDI), for anxiety using the State-Trait Anxiety Inventory (STAI), and QoL was assessed using the Korean version of the SmithKlein Beecham 'Quality of Life' Scale (KvSBQOL). Results : Compared with the CTCP group, the NCACP group reported significantly higher anxiety, and lower QoL. There was no significant difference in QoL between the two groups after adjusting for anxiety. The QoL was associated with depression and trait-anxiety in the CTCP group, and with trait-anxiety in the NCACP group. Conclusion : The findings suggest that there are different effects of depression and anxiety on QoL in individuals with CTCP and NCACP. Understanding about these differences can be important in the treatment of patients with chest pain. A large prospective study is needed to confirm these results.

• Journal of Yeungnam Medical Science
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• v.34 no.1
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• pp.128-131
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• 2017

Mid-ventricular obstruction (MVO) rarely occurs in patients without hypertrophic cardiomyopathy. Increased cardiac contractility may play an important role in causing MVO. We experienced a case of severe chest pain and MVO in a 50-year-old female patient. She had hypertension, diabetes, stroke and peripheral artery disease. Her blood pressure was very high (222/122 mmHg) with severe fluctuation. The transthoracic echocardiography revealed MVO accompanied by hyper-dynamic left ventricular systolic function. We regarded her chest pain and MVO as secondary findings related to other diseases. Coronary angiography and several tests for uncontrolled hypertension were performed, and those evaluations revealed that she had coronary artery disease and hyperthyroidism. We considered that the increase in the myocardial oxygen demand in response to the increase in cardiac contractility and workload associated with hyperthyroidism aggravated her symptoms and MVO. She was treated with methimazole and beta blockers and her symptoms dramatically improved.

• Journal of Chest Surgery
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• v.15 no.2
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• pp.218-221
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• 1982

Delayed cardiac tamponade in an uncommon and frequently fatal complication after open-heart surgery. We had been experienced two cases of delayed cardiac tamponade as a complication of open-heart surgery and treated successfully by reinsertion of pericardial drain through subxiphoid route. First case was 60 years old female patient and underwent MVR under impression of MSi + Ti Second case was 19 years old male patient and underwent total correction of T.O.F.with Blalock shunt [Lt]. Both cases had Initial symptoms, which were epigastric pain, chest tightness, dropped blood pressure, and increased pulse rate and respiratory rate, mimic as low cardiac output syndrome after open-heart surgery. Roentgenogram of the chest showed a rapid increased cardiothoracic ratio. It is important to realize the presence of late cardiac tamponade for proper diagnosis of complication after open-heart surgery.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.283-295
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• 1999

Background: Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were $1.1{\pm}0.9$ in non-cardiac diseases, $1.4{\pm}1.1$ in cardiac diseases and $1.7{\pm}1.1$ in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. Conclusion: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

• Journal of Chest Surgery
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• v.39 no.11 s.268
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• pp.858-860
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• 2006

Papillary fibroelastoma is the second most common benign cardiac tumor, usually involving the cardiac valve. Papillary fibroelastoma attached at the right coronary cusp of the aortic valve was found in a 51-year-old woman, who was presented with chest pain and dyspnea. During the operation, the tumor mass was excised without causing damage on the aortic valve leaflet.

• Journal of Chest Surgery
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• v.49 no.5
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• pp.366-373
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• 2016

Background: The aim of the study was to test the hypothesis that in patients with chronic complex sternum dehiscence, the use of muscle flap repair minimizes the occurrence of paradoxical motion of the chest wall (CWPM) when compared to sternal rewiring, eventually leading to better respiratory function and clinical outcomes during follow-up. Methods: In a propensity score matching analysis, out of 94 patients who underwent sternal reconstruction, 20 patients were selected: 10 patients underwent sternal reconstruction with bilateral pectoralis muscle flaps (group 1) and 10 underwent sternal rewiring (group 2). Eligibility criteria included the presence of hemisternum diastases associated with multiple (${\geq}$3) bone fractures and radiologic evidence of synchronous chest wall motion (CWSM). We compared radiologically assessed (volumetric computed tomography) ventilatory mechanic indices such as single lung and global vital capacity (VC), diaphragm excursion, synchronous and paradoxical chest wall motion. Results: Follow-up was 100% complete (mean $85{\pm}24months$). CWPM was inversely correlated with single lung VC (Spearman R=-0.72, p=0.0003), global VC (R=-0.51, p=0.02) and diaphragm excursion (R=-0.80, p=0.0003), whereas it proved directly correlated with dyspnea grade (Spearman R=0.51, p=0.02) and pain (R=0.59, p=0.005). Mean CWPM and single lung VC were both better in group 1, whereas there was no difference in CWSM, diaphragm excursion and global VC. Conclusion: Our study suggests that in patients with complex chronic sternal dehiscence, pectoralis muscle flap reconstruction guarantees lower CWPM and greater single-lung VC when compared with sternal rewiring and it is associated with better clinical outcomes with less pain and dyspnea.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.233-236
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• 2005

Cardiac hemangioma is an extremely rare benign tumor. A 65 years old woman was admitted due to epigastric and chest pain, After we confirmed cardiac tamponade with right atrial mass by chest CT, we performed surgical resection of the mass and identified hemangioma with capillary endothelial hyperplasia on pathologic examination. Therefore, we report the case with literature review.

• Journal of Chest Surgery
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• v.10 no.1
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• pp.173-178
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• 1977

A 51 year old man was admitted to the Thoracic and Cardiovascular Department of Kyungpook University Hospital on April 7, 1976, with chief complaints of orthopnea and the chest pain for about 3 months. Physical examination showed narrow pulse pressure, puffy face, engorged neck veins at sitting position, distant heart sound, enlarged liver and edematous upper extremities. The chest roentgenogram demonstrated markedly enlarged cardiac silhouette. Low voltage and the low to diphagic T`s were noted on the electrocardiogram. Paroxysmal ventricular tachycardia was developed intermittently and was subsided spontaneously. Repeated pericardiocentesis were performed each of which yielded from 100 to 300ml. but intractable cardiac failure was progressed. The bacteriology and cytology of the pericardial fluid were not revealed any specific findings. The pericardiectomy was performed to release the intractable cardiac tamponade. Pericardium was found to be thickened and cardiac constriction was noted. The thickened pericardium was easily removed. A large hen`s egg sized dark blue tumor mass occupied the anterior wall of the right atrium and two thumb tip sized pearl gray tumors were placed at the just below portion of the main pulmonary artery. The biopsy report revealed primary fibrosarcoma of the heart. The patient was improved from the symptoms of the cardiac failure during the postoperative course.

• The Journal of the Society of Stroke on Korean Medicine
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• v.15 no.1
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• pp.72-79
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• 2014

A 44-year-old male complained of chest pain. Two years ago he was diagnosed with angina pectoris for stenosis of coronary artery in coronary angiography. Despite of medication, his chest pain aggravated to cardiovascular society classification class III. His electrocardiogram, cardiac enzymes were normal. Accordingly we diagnosed him with unstable angina. And we pattern differentiated him with heart heat syndrome considering his other symptoms. He wanted conservative care instead of coronary artery intervention generally recommended for treating unstable angina. We treated him for 13-days with tongxinluo, modified daochi-san, acupuncture, smoking prohibition which were thought to be effective for treating unstable angina based on experimental, clinical studies. Within the therapeutic period, frequency of chest pain and frequency of taking nitroglycerin were on the decrease.

• The Journal of the Society of Stroke on Korean Medicine
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• v.10 no.1
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• pp.74-80
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• 2009

Myocardial bridging, a congenital coronary anomaly, is present when a segment of a major epicardial coronary artery, runs intramurally through the myocardium. So with each systole, the coronary artery is compressed. It has been associated with angina, arrhythmia, myocardial infarction and sudden cardiac death. This is a case of a 39-year-old woman who was diagnosed myocardial bridge. She complained of recurrent chest pain, palpitation. We diagnosed her as Gyesimtong(JiXiTong, 悸心痛), and prescribed Jeongkicheonhyang-tang(正氣天香湯). After treatment, all of the symptoms had improved and have not recurred for 18 months. This case suggests that oriental medicine therapy can be applicable to improve in symptoms of myocardial bridge.