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In-flight angina pectoris; an unusual presentation

Overview of attention for article published in BMC Cardiovascular Disorders, April 2018
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Title
In-flight angina pectoris; an unusual presentation
Published in
BMC Cardiovascular Disorders, April 2018
DOI 10.1186/s12872-018-0797-1
Pubmed ID
Authors

Firas Al-Janabi, Regina Mammen, Grigoris Karamasis, John Davies, Thomas Keeble

Abstract

An unusual case of typical angina which occurred on a long haul flight is presented. This case is notable as this was the index presentation, with no previous symptoms prior to this. Physiological changes at altitude can be marked, and include hypoxia, tachycardia and an increase in cardiac output. These changes were enough to expose underlying angina in our patient. A 68 year old man presented with typical cardiac chest pain on a long haul flight. His symptoms first started 10-15 min after take-off and resolved on landing. This was his index presentation, and there were no similar symptoms in the past. Background history included hypercholesterolaemia and benign prostatic hypertrophy only. He led a rather sedentary lifestyle. A CT coronary angiogram showed significant disease in the proximal left anterior descending artery and proximal right coronary artery. He went on to have a coronary angiogram with invasive physiological measurements, which determined both lesions were physiologically significant. Both arteries were treated with drug eluting stents. Since treatment, he once again embarked on a long haul flight, and was completely asymptomatic. The presentation of symptoms in this individual was rather unusual, but clearly caused by significant coronary artery disease. Potentially his sedentary lifestyle was not enough in day-to-day activities to promote anginal symptoms. When his cardiovascular system was physiologically stressed during flight, brought about by hypoxia, raised sympathetic tone and increased cardiac output, symptoms emerged. In turn, when landing, with atmospheric conditions normalised, physiological stress was removed, and symptoms resolved. Clinically therefore, one should not exclude symptoms that occur with differing physiological states, such as stress and altitude, as they are also potential triggers for myocardial ischaemia, despite absence of day-to-day symptoms.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 15 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 15 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 3 20%
Student > Bachelor 2 13%
Student > Ph. D. Student 1 7%
Other 1 7%
Student > Master 1 7%
Other 2 13%
Unknown 5 33%
Readers by discipline Count As %
Nursing and Health Professions 4 27%
Medicine and Dentistry 4 27%
Materials Science 1 7%
Unknown 6 40%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 May 2018.
All research outputs
#9,867,839
of 12,889,535 outputs
Outputs from BMC Cardiovascular Disorders
#512
of 808 outputs
Outputs of similar age
#186,747
of 269,761 outputs
Outputs of similar age from BMC Cardiovascular Disorders
#1
of 1 outputs
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