The coxsackievirus is well known for its vastly differing clinical presentations.Patients with coxsackievirus usually present with a viral prodrome which can then progress to the cardiac symptoms of chest pain and/or ...The coxsackievirus is well known for its vastly differing clinical presentations.Patients with coxsackievirus usually present with a viral prodrome which can then progress to the cardiac symptoms of chest pain and/or palpitations.Most patients improve quickly with simply supportive care and nonsteroidal anti-inflammatory medications.展开更多
An 80-year-old male with type Ⅱ diabetes mellitus,hypertension and hyperlipidemia presented with chest pain.Vital signs were significant for severely elevated blood pressure of 190/100 mmHg,but otherwise normal.Physi...An 80-year-old male with type Ⅱ diabetes mellitus,hypertension and hyperlipidemia presented with chest pain.Vital signs were significant for severely elevated blood pressure of 190/100 mmHg,but otherwise normal.Physical examination was unrevealing.Chest X-ray and electrocardiogram were unremarkable.In Figure 1A,the transthoracic echocardiogram demonstrated an ejection fraction of 55%–60%with a parachute mitral valve(PMV),which had no stenosis or regurgitation.The patient’s chest pain resolved with normalization of his blood pressure and he was discharged with medical management.展开更多
A 71yearold well controlled hypertensive female presented on day 4 of acute COVID19 illness with atypical chest pain and worsening exertional dyspnea.On examination,heart rate was 110 beats/min,blood pressure was 125/...A 71yearold well controlled hypertensive female presented on day 4 of acute COVID19 illness with atypical chest pain and worsening exertional dyspnea.On examination,heart rate was 110 beats/min,blood pressure was 125/82 mmHg and there were decreased heart sounds with visible jugular venous distention.She was not in respiratory distress at rest and was not requiring supplemental oxygen.Chest radiography showed bilateral diffuse opacities(Figure 1).transthoracic echocardiography(TTE)confirmed a moderate pericardial effusion with right ventricular systolic compression,paradoxical right ventricular septal motion,enddiastolic right atrial collapse,and a plethoric inferior vena cava(IVC)with no respiratory variation.Her ejection fraction(EF)was 55%.Initial workup revealed mildly elevated troponin T levels of 0.14 ng/mL,NTPro BNP of 2500 pg/mL.展开更多
A 64-year-old male with a history of thoracic aortic ulcer s/p thoracic endovascular aortic repair presented to the hospital with typical chest pain.His initial physical exam was unremarkable.Cardiac biomarkers were n...A 64-year-old male with a history of thoracic aortic ulcer s/p thoracic endovascular aortic repair presented to the hospital with typical chest pain.His initial physical exam was unremarkable.Cardiac biomarkers were negative on admission and electrolytes were within normal limits.展开更多
文摘The coxsackievirus is well known for its vastly differing clinical presentations.Patients with coxsackievirus usually present with a viral prodrome which can then progress to the cardiac symptoms of chest pain and/or palpitations.Most patients improve quickly with simply supportive care and nonsteroidal anti-inflammatory medications.
文摘An 80-year-old male with type Ⅱ diabetes mellitus,hypertension and hyperlipidemia presented with chest pain.Vital signs were significant for severely elevated blood pressure of 190/100 mmHg,but otherwise normal.Physical examination was unrevealing.Chest X-ray and electrocardiogram were unremarkable.In Figure 1A,the transthoracic echocardiogram demonstrated an ejection fraction of 55%–60%with a parachute mitral valve(PMV),which had no stenosis or regurgitation.The patient’s chest pain resolved with normalization of his blood pressure and he was discharged with medical management.
文摘A 71yearold well controlled hypertensive female presented on day 4 of acute COVID19 illness with atypical chest pain and worsening exertional dyspnea.On examination,heart rate was 110 beats/min,blood pressure was 125/82 mmHg and there were decreased heart sounds with visible jugular venous distention.She was not in respiratory distress at rest and was not requiring supplemental oxygen.Chest radiography showed bilateral diffuse opacities(Figure 1).transthoracic echocardiography(TTE)confirmed a moderate pericardial effusion with right ventricular systolic compression,paradoxical right ventricular septal motion,enddiastolic right atrial collapse,and a plethoric inferior vena cava(IVC)with no respiratory variation.Her ejection fraction(EF)was 55%.Initial workup revealed mildly elevated troponin T levels of 0.14 ng/mL,NTPro BNP of 2500 pg/mL.
文摘A 64-year-old male with a history of thoracic aortic ulcer s/p thoracic endovascular aortic repair presented to the hospital with typical chest pain.His initial physical exam was unremarkable.Cardiac biomarkers were negative on admission and electrolytes were within normal limits.
