Chest Pain in Patients Under Age 40: Are We Getting It Right?

Morgenstern, Daniel A.; Kley, Julian; Lisko, John; Shivers, Luke; Mikolich, Brandon; Mikolich, J. Ronald

doi:10.1016/s0735-1097(15)61298-0

Cited by 5 publications

(2 citation statements)

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“…708 пациентов с болью в груди и исключенной ИБС выявило, что 143 (20%) из них страдали от перикардита, не вы-явленного по стандартным диагностическим крите риям и подтвержденного только МРТ [9]. В 2015 г. также крупное МРТ-исследование с включением 931 пациента с болью в груди показало еще большую распространенность перикардита, особенно в когорте пациентов младше 40 лет (24,3%) [13]. Распространенность перикардита в популяции на тот момент рассчитывалась как 27 на 100 000 человеко-лет [6].…”

Section: Discussionunclassified

“…С одной стороны, это подчеркивает важность описания "сухих" изменений для диагностики плеврита, с другой -актуализирует преимущества таких методов, как УЗИ и МРТ [34]. Развитие плеврита без пневмонита также может быть спровоцировано ТЭЛА, триггером которой явилась SARS-CoV-2 [13]. В нашей работе, несмотря на то что пациенты с известной ТЭЛА не анализировались, нельзя исключать подобный сценарий у 12 пациентов с признаками легочной гипертензии.…”

Section: Discussionunclassified

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Pleurisy and pericarditis as a cause of atypical chest pain in patients with in early post-COVID-19 period

Sukmarova¹,

Ибрагимова²,

Larina

et al. 2022

Medicinskaâ vizualizaciâ

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During the pandemic COVID-19, there has been an increase in the number of patients with non-anginal chest pain at cardiologist appointments.Objective. To assess the incidence of signs of pleurisy and pericarditis after COVID-19 in non-comorbid patients with atypical chest pain and describe their characteristics according to echocardiography and magnetic resonance imaging.Materials and methods. From February 2021 to January 2022, 200 outpatients were prospectively enrolled in the study, all of them suffered from a discomfort in the heart region for the first time after SARS-CoV-2 infection. Inclusion criteria: 18–50 years old, 5–12 weeks after SARS-CoV-2 infection, non-anginal chest pain. Exclusion criteria: pneumonia or signs of pulmonary thromboembolism, coronary heart disease, congestive heart failure or kidney disease, clinical or laboratory signs of myocarditis, oncopathology, radiation or chemotherapy of the chest in past medical history. A survey was conducted (yes/no) for the presence of general malaise, quality of life deterioration, hyperthermia, cough. Ultrasound examination of the pericardium and pleura to detect effusion or postinflammatory changes was performed in accordance with the recommendations. Magnetic resonance imaging was performed if ultrasound imaging was poor or there was no evidence of pericardial or pleural involvement in patients with typical symptoms.Results. 82 women and 118 men were included. Median of age 39 [28–46] years old. Pericarditis was diagnosed in 152 (76%) patients, including effusive pericarditis in 119 (78%), myocarditis in 6 (3%) and myopericarditisin 49 (25%) patients, pleurisy was detected in 22 (11%) patients, exudative pleurisy – in 11 (5.5%) patients with a predominant unilateral lesion of the mediastinal-diaphragmatic region adjacent to the heart. Hyperthermia was recorded in 2.5% of cases, general malaise – in 60% and a decrease in the quality of life – in 84%.Conclusion. Serositis as a cause of atypical chest pain among young non-comorbid patients in early postCOVID was identified in 87% of patients. In the coming years, it is probably worthwhile to perform ultrasound of the pericardium and pleura in all patients with chest pain.

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Section: Discussionunclassified