Background: Chest Pain is one of the most frequent causes of a child’ s referral to a cardiologist. Objectives: The present study aimed at determining whether treatment of constipation in 4-17-year-old children with idiopathic Chest Pain stops their Chest Pain. Methods: The current descriptive study was conducted on all patients aged 4-17 years old with idiopathic Chest Pain referring to the Pediatric Cardiology Clinic of Hejazi Hospital, Shiraz, Iran in 2016. A diagnosis of idiopathic Chest Pain is established after a thorough history taking, physical examination, and appropriate laboratory investigations in patients with no abnormality in the heart, lung, musculoskeletal system, psychological condition, and upper gastrointestinal tract. The study patients were divided into two groups: 36 patients with constipation as cases and 27 patients without constipation as controls. Patients with constipation were supported with toilet training programs and pharmacological treatment. Relief of Chest Pain was evaluated in the two groups after four months. Results: There were no significant differences in terms of age, gender, weight, and height between the patients with idiopathic Chest Pain with and without constipation. The number and length of Chest Pain were significantly different between the case and control groups (P < 0. 001 and 0. 047, respectively). After medical treatment of constipation, Chest Pain was significantly stopped in patients with constipation compared with the ones without constipation (P < 0. 001). Conclusions: The current study showed that resolution of constipation stopped Chest Pain in the patients with idiopathic Chest Pain and constipation. Physicians should consider treatment of constipation as a first modality in each patient with idiopathic Chest Pain and constipation due to its easy assessment.

A 67-year-old woman presented to our clinic with 5 years history of intermittent dysphasia. She described dysphasia during the intake of solid food and sometimes with liquid food. She did not note abdominal Pain, hematemesis, or melena, but in the past two years, she noted a weight loss of 5 kgs. Her medical history was significant only for hypertension, which was controlled by 100 mg daily dose of metoprolol in divided doses. She occasionally took non-steroidal anti-inflammatory drug (NSAID). Physical examination did not reveal any finding.....

Introduction: Acute coronary syndrome accounts formore than 15% of the Chest Pains. Recently, Hess et al. developed North American Chest Pain Rule (NACPR) to identify very low-risk patientswho can be safely discharged from emergency department (ED). The present study aimed to validate this rule in EDs of two academic hospitals. Methods: A prospective diagnostic accuracy study was conducted on consecutive patients 24 years of age and older presenting to the ED with the chief complaint of acute Chest Pain, during March 2013 to June 2013. Chest Pain characteristics, cardiac history, electrocardiogram findings, and cardiac biomarker measurement of patients were collected and screening performance characteristics of NACPR with 95% confidence interval were calculated using SPSS 21. Results: From 400 eligible patients with completed follow up, 69 (17.25 %) developed myocardial infarction, 121 (30.25%) underwent coronary revascularization, and 4 (2%) died because of cardiac or unidentifiable causes. By using NACPR, 34 (8.50%) of all the patients could be considered very low- risk and discharged after a brief ED assessment. Among these patients, none developed above-mentioned adverse outcomes within 30 days. Sensitivity, specificity, positive prediction value, and negative prediction value of the rule were 100% (95% CI: 87.35 - 100.00), 45.35 (95% CI: 40.19 - 50.61), 14.52 (95% CI: 10.40 - 19.85), and 100 (95% CI: 97.18 - 100.00), respectively. Conclusion: The present multicenter study showed that NACPR is a good screening tool for early discharge of patients with very low-risk Chest Pain from ED.

Macicnant plevral mesothestioma is a primary neoplasm of the plevra asbestos exposune Is known to bean important risk factor in about 80% of cases. Ths case report presents A 32 yr old man who has no history of asbestos onset plevrstsl ChestPain whsch msmecs pulmonary in farction. Due to embols. By reviewing the records there are few case of sudden onset pasn. In addstion pleuritic pasn was awother unusuas Fea ture of the pasent.

Background: Broad Beta disease is one of the genetically disorders in lipoprotein that cause aggregation of lipoprotein in plasma and Incidence risk of Ischemic heart disease among these patients is high.Case presentation: An eight year old boy was admitted to the hospital because of an abrupt onset Chest Pain, faint and ST depression in inferior leads. He has been well one day earlier, when an exertional Chest Pain developed. Laboratory values obtained before admission showed hypercholesterolemia, and physical exam showed mild supravalvular aortic stenosis. ECG: ST depression in inferior leads. TT Echo: Mild supravalvular aortic stenosis. Angiography: Three vessel disease. Lab: Only hypercholesterolemia. (Cholesterol upper than 400 mg/100). Treatment: CABG, Three graft.Conclusion: There are few data regarding the preoperative risk in patients with hypercholesterolemia. In patients with familial hypercholesterolemia, there is a high incidence of premature Coronary Artery Disease.These patients are also at risk for both valvular and supravalvular aortic stenosis as well as atherosclerosis of the carotid and femoral arteries. There is a higher than expected incidence of proximal lesions in the coronery and in the left main artery in patients with familial hypercholesterolemia.

WHAT IS YOUR DIAGNOSIS? A 14-year-old boy was referred to our hospital with Pain in his left posterior Chest wall, cough, exertional dyspnea, weight loss, shoulder Pain and inability to move his left hand. He had a history of Chest trauma two weeks ago. During the past two weeks, he had two episodes of nausea and vomiting. During his admission to emergency department, his vital signs including blood pressure, heart rate, respiratory rate and oxygen saturation rate were normal. On physical examination, coarse crackles were auscultated in basal left lung and breath sounds were normal in other areas. Laboratory tests showed leukocytosis (WBC: 12. 2×103) and PLT 460×103. CRP was positive (3+) and ESR was 96 mm/h. Sputum culture was also positive for Candida.

Background: Brucellosis pericarditis is an extremely rare involvement of the cardiovascular system with Brucella species that has worldwide distribution and is endemic in many provinces of Iran.Case presentation: The present report describes an exceptional case of pericardial involvement by Brucella melitensis in a 50- year-old woman. The patient presented with night sweats, mild fever, weight loss, and Chest Pain.Conclusion: Pericarditis occurs during the course of brucellosis as an isolated cardiac symptom and may be asymptomatic or may be manifested with Chest Pain as ischemic heart disease.

Intrathoracic kidney is a rare congenital anomaly, with only about 50 cases reported in the literature to date. It comprises less than 5% of all ectopic kidney disorders. However, it should be included in the differential diagnosis of posterior mediastinal masses as confirmation of the diagnosis obviates the need for further clinical studies, further treatment, or unnecessary surgical operation. Chest computed tomography is an important and efficient tool in confirming the diagnosis. We report a case of a 72-year-old woman who suffered from nonspecific Chest Pain for 3 years. Chest radiography revealed a left posterior mediastinal mass which was later confirmed by Chest computed tomography to be a congenital intrathoracic kidney.