• 제목/요약/키워드: Cardiac chest pain

검색결과 141건 처리시간 0.026초

흉부 통증을 호소한 소아에서의 임상적 고찰 및 검사 (Clinical Evaluation and Diagnosis of Children with Chest Pain)

  • 신수아;김용주;이재환;김남수;문수지
    • Clinical and Experimental Pediatrics
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    • 제46권12호
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    • pp.1248-1252
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    • 2003
  • 목 적 : 소아에 있어서 흉부 통증은 재발성 복통과 더불어 소아과 영역에서 흔히 접하게 되는 문제로, 정확한 원인을 규명하기란 쉽지 않으며 다양한 원인에 의해 발현된다. 소아에서의 흉부 통증은 양성적이고 통증의 경과가 양호하며, 원인을 모르는 경우가 많아 이런 환아들에게서 행해지는 검사가 어떠한 의의가 있는지에 대해서도 정보가 그리 많지 않다. 이에 저자들은 소아 흉부 통증 환자의 특징에 대해 알아보고 검사의 유용성에 대해 알아보고자 본 연구를 시행하였다. 방 법 : 한양대학교병원 소아과에 만성적 흉부 통증을 주소로 내원한 환아 33명(남아 15명, 여아 18명)을 대상으로 흉부 통증의 원인 및 시행하였던 검사들에 대한 결과를 후향적으로 분석하였다. 결 과 : 대상 환아의 연령은 10-12세 사이와 4-6세 사이가 각각 11례(33.3%)로 가장 많은 분포를 보였으며 남, 여 성별의 차이는 없었다. 흉부 통증의 원인으로는 특발성이 15례(45.5%), 심혈관계 검사의 이상을 보인 경우 9례(27.3%), 위장관 질환 6례(18.2%), 호흡기 질환 2례(6%), 흉부 좌상 1례(3%) 순이었다. 대상 환아들에서 보인 심혈관계 검사상 이상 소견은 흉부 통증과 직접적 연관이 있다고 하기 어려웠다. 병력 청취 및 진찰을 통해 상부 위장관 질환이 의심되는 6례에서 이에 대한 검사를 시행하였고 모두에서 상부 위장관 질환의 소견이 관찰되었으며 이에 대한 치료 이후 증상의 재발은 관찰되지 않았다. 결 론 : 소아에서의 흉부 통증은 양성적이고 특발성인 경우가 많으나 심혈관 질환이나 위장관 질환 등의 가능성도 생각해야하며 이를 위해 정확한 병력 청취 및 진찰에 근거해 적절한 검사를 시행함으로써 효과적인 진단 및 치료가 가능할 것이다.

응급실에서 심자도의 역할 (Role of Magnetocardiography in Emergency Room)

  • 권혁찬;김기웅;김진목;이용호;김태은;임현균;박용기;고영국;정남식
    • Progress in Superconductivity
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    • 제8권1호
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    • pp.40-45
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    • 2006
  • In emergency rooms, patients with acute chest pain should be diagnosed as quickly as possible with higher diagnostic accuracy for an appropriate therapy to the patients with acute coronary syndrome or for avoiding unnecessary hospital admissions. At present, electrocardiography(ECG) and biochemical markers are generally used to detect myocardial infarction and coronary angiography is used as a gold standard to reveal the degree of narrowing of coronary artery. Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool fur the detection of cardiac electrical abnormality associated with myocardial ischemia. In this study, we examined whether the MCG can be used fur the detection of coronary artery disease(CAD) in patients, who were admitted to the emergency room with acute chest pain. MCG was recorded from 36 patients admitted to the emergency room with suspected acute coronary syndrome. The MCG recordings were obtained using a 64-channel SQUID MCG system in a magnetically shielded room. In result, presence of CAD could be found with a sensitivity of 88.2 % in patients with acute chest pain without 57 elevation in ECG, demonstrating a possible use in the emergency room to screen CAD patients.

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전기경련요법에 의하여 유발된 심부정맥(PVC) 1례 (A Case of ECT-induced Arrhythmia(PVC))

  • 김덕호;이호택;백주희;이상연
    • 정신신체의학
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    • 제5권2호
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    • pp.214-217
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    • 1997
  • Electroconvulsive therapy(ECT) is one of the most effective treatment modalities for the treatment of depression, mania, schizophrenia, or other neuropsychiatric disorders. But, reportedly ECT also can produce various forms of cardiac arrhythmia. We experienced a case of ECT-induced arrhythmia(PVC) accompanied with chest pain in a schizophrenic patient during the course of plain ECT. We conclude that there is a possible causal relationship between ECT and cardiac arrhythmia(PVC). The mechanisms of cardiac arrhythmia(PVC) due to ECT may be explained by the effects of ECT to vagal and sympathetic nervous systems. from this case report, We suggest that careful cardiac monitoring before, during, and after ECT with appropriate anesthetic preparation to a patient may enable to minimize the cardiovascular side effects of ECT in the patients with neuropsychiatric disorders.

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등산 중 발생하는 심정지 주의에 따른 안전산행 연구 (A Study on Safe Hiking According to Caution Against Cardiac Arrest That Occurs Unexpectedly during Mountaineering)

  • 박옥남;오혜령
    • 한국재난정보학회:학술대회논문집
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    • 한국재난정보학회 2023년 정기학술대회 논문집
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    • pp.129-130
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    • 2023
  • The From COVID-19 until recently, the demand for hiking has been rapidly increasing due to the popularization of mountain seekers.,On weekends and holidays, people who do not hike frequently while hiking in large and small mountains to see wildflowers and foliage in the mountains are more likely to be exposed to safety accidents due to an increase in sudden muscle use.,If you fall or get muscle damage during a hike, you can prevent a major accident with a simple treatment. In some cases, the error of first aid may permanently damage the important function of the body.,In particular, during a safety accident on a mountain, while climbing in light clothes, the body temperature rises due to the sweat that was shed at the beginning, and the blood pressure rises due to the contraction of the blood vessels due to the drop in body temperature from the top, resulting in an emergency such as cardiac arrest.,According to statistics from the National Park Service, nearly half (48%) of deaths in national parks are known to be sudden cardiac deaths.,There are many safety accidents that occur frequently in the mountains, but among them, we will study how to cope with acute diseases such as cardiac arrest due to increased blood pressure due to insufficient body temperature control, chest pain or dyspnea, and heart burden due to excessive hiking.

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협심증 증상을 동반한 심낭내 원발성 지방종 (Primary Cardiac Lipoma Combined with Chest Pain Like Angina Pectoris)

  • 김정태;오태윤;장운하
    • Journal of Chest Surgery
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    • 제39권4호
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    • pp.320-322
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    • 2006
  • 60세 남자 환자가 호흡곤란 및 협심증을 의심케 하는 흉통을 주소로 내원하였다. 시행한 비침습성 검사상 좌심방 후면에 종양이 발견되었다. 심폐기하에서 종양제거술을 시행하였다. 종양은 좌심방에서 기시하였으며 다른 장기로의 침범은 없었다. 조직검사상 부분 괴사를 동반한 성숙 지방 세포였으며 지방종으로 확진되었다. 이에 심낭 내 좌심방에서 기원한 드문 심장 지방종을 발표하는 바이다.

자연 기흉의 정도에 따른 호흡 및 순환 생리의 변화에 관한 고찰 (Changes in Respiratory & Circulatory Physiology Caused by Various Degrees of Spontaneous Pneumothorax)

  • 김영대;정황규
    • Journal of Chest Surgery
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    • 제27권9호
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    • pp.770-778
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    • 1994
  • Here analized the chest physiologic changes caused by various degrees of spontaneous pneumothorax in 77 patients admitted in Pusan National University Hospital from Jan. 1991 to Aug.1992. The results were summarized as follow: 1. There were 59 patients of primary spontaneous pneumothorax and 18 of secondary spontaneous pneumothorax. 2. The intrapleural pressure risings were paralled to the increasing sizes of pneumothorax, especiallythe intrapleural pressure changes were significant in large pneumothorax. In the secondary spontaneous pneumothoraces the intrapleural pressure were relatively higher than primary in the same sizes of pneumothorax. 3. The intensity of chest pain was paralled to the increasing sizes and intrapleural pressures of the pneumothorax, but the degrees of dyspnea had no linear interrelationship. 4. The pulse rate, cardiac output, and arterial PO2 started to change from positive intrapleural pressure, and significant changes were noted between 6 to 9 mmHg of intrapleural pressure. But the arterial PCO2 changes had no interrelationship to the degrees of pneumothorax.

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심장내 이물질: 선행 원인이 불분명한 환자에서 발견된 우심실내 봉합침 (Intracardiac Foreign Body: A Sewing Needle in Right Ventricle of Unknown Etiology)

  • 김경환;장지민;안혁
    • Journal of Chest Surgery
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    • 제33권8호
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    • pp.681-683
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    • 2000
  • A 34 year-old woman was hospitalized with anterior chest pain and indigestion. Chest radiograph and computed tomogram revealed a sewing needle in the cardiac cavity. She had no histories of surgical intervention, drug abuse, or acupuncture. We removed the needle from the right ventricle under cardiopulmonary bypass.

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급성 심근경색증환자의 임상적 증상과 치료추구시간의 지연 (A Survey on the Delay Time Before Seeking Treatment and Clinical Symptoms in Patients with Acute Myocardial Infarction)

  • 박오장;김조자;이향련;이해옥
    • 대한간호학회지
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    • 제30권3호
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    • pp.659-669
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    • 2000
  • Many patients of acute myocardial infarction showed delay time before seeking treatment although they needed immediate thrombolytic therapy once they perceived their symptoms. The objectives of this study were to identify the relationship between clinical symptoms and the delay, and to find the time spent before seeking the treatment. This study was a retrospective research. The delay time for the treatment consisted of the length of delay from symptom onset to patients' decision (T1), from patients' decision making to finding transportation (T2), and from taking transportation to the first hospital arrival(T3). The subjects were 89 patients who were admitted in the ICU and Cardiac Ward at Chonnam University Hospital with the first attack of acute myocardial infarction. Center, USA The data was collected for three months from March 1st to May 31st of 1998 through questionnaires and reviewing patients' charts: The chart information was suppled by two nurses working at the ICU and Cardiac Ward. The data was analyzed by using frequency, mean and ANOVA through the SAS program. The results of study summarized as follows: 1. Sixty two patients (69.7%) were male and twenty seven patients (30.3%) were female, the ratio of male to female was 2.3 : 1. 2. In daily life, the 70.8% of the patients felt chest pain and discomfort fatigue in 67.4%, dyspnea in 57.3%, and pain in arm, neck, and jaw in 52.8%. During the attack, 97.8% of the patients felt chest pain and discomfort dyspnea in 82.1%, pain in arm, neck, jaw in 67.4% and perspiration in 51.7%. 3. The length of time a patient spent seeking time for treatment (T1+T2+T3) was 94.6 minutes, in which the time for patients' decision making for treatment (T1) was 70.3 minutes, time for finding transportation (T2) was 8.2 minutes, and time for the transportation of the patient to the first hospital (T3) was 16.1 minutes. Time for patients' decision making to go to a hospital(T1) was 74.2% of the total time sought for treatment. 4. The differences of time sought for treatment between perceptions about the seriousness of the symptoms were significant (F= 6.5, p< .01). The more serious the heart symptoms they felt, the shorter the seeking time for treatment. 5. The differences of the time delay before treatment between the degree of the symptoms were significant (F= 2.9, p< .05). The patients with the typical chest pain and discomfort spent shorter the seeking time for treatment than those with the atypical symptoms of acute myocardial infarction. 6. The differences of transportation time to the first hospital between the types of cars that the patients used, were significant (F= 4.3, p< .01). When the patients used 119 or 129 they spent the least time (5.3 minutes) for transportation, and followed by way of an ambulance (15.6 minutes), private car (20.6 minutes), and taxi (24.8 minutes).

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Neonatal Patent Ductus Arteriosus Ligation Operations Performed by Adult Cardiac Surgeons

  • Chung, Yoon Sang;Cho, Dai Yun;Kang, Hyun;Lee, Na Mi;Hong, Joonhwa
    • Journal of Chest Surgery
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    • 제50권4호
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    • pp.242-246
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    • 2017
  • Background: Patent ductus arteriosus (PDA) ligation is usually performed by congenital cardiac surgeons. However, due to the uneven distribution of congenital cardiac surgeons in South Korea, many institutions depend solely on adult cardiac surgeons for congenital cardiac diseases. We report the outcomes of PDA ligations performed by adult cardiac surgeons at our institution. Methods: The electronic medical records of 852 neonates at Chung-Ang University Hospital, Seoul, South Korea from November 2010 to May 2014 were reviewed to identify patients with PDA. Results: Of the 111 neonates with a diagnosis of PDA, 26 (23%) underwent PDA ligation. PDAs were ligated within 28 days of birth (mean, $14.5{\pm}7.8days$), and the mean gestational age of these patients was $30.3{\pm}4.6weeks$ (range, 26 to 40 weeks) with a mean birth weight of $1,292.5{\pm}703.5g$ (range, 480 to 3,020 g). No residual shunts through the PDA were found on postoperative echocardiography. There was 1 case of 30-day mortality (3.8%) due to pneumonia, and 6 cases of in-hospital mortality (23.1%) after 30 days, which is comparable to results from other centers with congenital cardiac surgery programs. Conclusion: Although our outcomes may not be generalizable to all hospital settings without a congenital cardiac surgery program, in select centers, PDA ligations can be performed safely by adult cardiac surgeons if no congenital cardiac surgery program is available.

경부 경막외 마취중 발생한 Bezold-Jarisch 반사 -2예 보고- (Bezold-Jarisch Reflex during Cervical Epidural Anesthesia -Two case reports-)

  • 이경진;민상기;한상건;이성중;김명은;문봉기;이영석
    • The Korean Journal of Pain
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    • 제11권1호
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    • pp.143-145
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    • 1998
  • There are reports on cervical epidural anesthesia for surgery of neck, chest and upper limb. However, there are limited published data on the specific problems with this procedure, including dural puncture, epidural abscess, and vasovagal syncopes. We experienced two cases of vasovagal syncope during cervical epidural anesthesia in the sitting position. These syncopes consisted of sudden hypotention and bradycardia, associated with nausea, dizzness and sweating. The patients were resuscitated successfully and recovered without any adverse effects. Current literature is being reviewed and the possible mechanisms of cardiac arrest under cervical epidural anesthesia in the sitting position are being discussed.

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