China
Africa
Explore chapters and articles related to this topic
Cardiovascular Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Abdominal aortic aneurysms present in one of three ways: as an asymptomatic finding on routine clinical examination, as a cause of epigastric pain or pain in the back, and a pulsatile mass found on examination, or if leaking, with acute pain, hypotension and a pulsatile mass in the abdomen.
Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Plain radiography: the ‘aortic knuckle’ on a chest radiograph represents the right lateral and superior border of the arch of the aorta. An aneurysm of arch may enlarge the knuckle, but a similar appearance can be produced by senile unfolding/elongation. In dissecting and traumatic aneurysm of the aorta the aortic knuckle is often normal or nearly normal. The abdominal aorta will only be clearly seen if there is significant mural calcification. Occasionally an aneurysm of the abdominal aorta will be detected incidentally this way; however, it is unreliable and ultrasound screening means this presentation is likely to become rare. Plain film radiography is thus insufficient for complete imaging of any part of the aorta, though it will usually form part of the preliminary work-up in the emergency situation.
Triggers and Narratives
Published in Meredith Mealer, Rowan Waldman, Coping with Caring, 2019
A patient was admitted recently to our inpatient unit from a rural outside hospital in Wyoming. The patient was diagnosed with an actively dissecting abdominal aortic aneurysm. She was educated on her options for medical and surgical treatment once she was flown to the hospital for care. Her two options were to undergo surgical intervention to amend her critical condition or to die relatively quickly without surgical intervention. She opted to forgo surgery and completely understood the implications of her decision.
Abdominal aortic calcification score can predict all-cause and cardiovascular mortality in maintenance hemodialysis patients
Published in Renal Failure, 2023
Jiuxu Bai, Aihong Zhang, Yanping Zhang, Kaiming Ren, Zhuo Ren, Chen Zhao, Qian Wang, Ning Cao
The presence and degree of arterial calcification is considered to be one of the major determinants of the CVD incidence rate and mortality, and this occurs through various mechanisms. The abdominal aorta is a susceptible site for atherosclerosis and calcification. Therefore, the presence of AAC may be related to the occurrence of cardiovascular disease and patient death, and it is a very common complication in patients with ESKD [16]. Arterial calcification is characterized by lesions that occur in the medial vascular wall, which exacerbates arterial stiffness and is termed arteriosclerosis in the CKD population [17]. The AAC score can predict the occurrence of future CAD events in ESKD patients [18]. AAC was also associated with an increased risk of congestive heart failure [19]. The increased mortality caused by AAC may be due to the greater degree of generalized atherosclerosis and greater rate of occlusive lesions. Advanced aortic sclerosis with aortic calcification is associated with decreased aortic compliance, which increases the burden on the heart and increases the risk of cardiovascular death [20].
Characterising recovery following abdominal aortic aneurysm repair using cardiopulmonary exercise testing and patient reported outcome measures
Published in Disability and Rehabilitation, 2023
N. Dodds, J. Angell, S. L. Lewis, M. Pyke, P. White, A. Darweish-Medniuk, D. C. Mitchell, S. Tolchard
Forty-two patients undergoing abdominal aortic aneurysm (AAA) repair, by open (n = 21) or endovascular (EVAR; n = 21) approach, were recruited in the vascular outpatient’s clinic or during pre-operative assessment between 2010 and 2015. Informed consent was obtained by a consultant or clinical research fellow trained in Good Medical Practice. All patients received consultant-delivered surgical and anaesthetic care. The study received local ethical approval from our local Health Research Authority, Bristol NRES Southwest, with restrictions that limited the study design such that it was not possible to recruit consecutive patients. Patients over the age of 18 years were considered for the study, with the following exclusions; Patients that suffered post-operative complications or were considered inoperable, those patients unable or unwilling to perform an ergometer test or participate in the study, and patients from outside the Bristol area for whom participation would represent a significant burden. The approval also stipulated that patients not be re-tested within 4 weeks of surgery. The study incorporated patient safety pathways to identify patients with potentially reversible cardiac or pulmonary morbidity; in such cases, the surgeon was informed and the patient referred to the appropriate specialty. None of the patients in the study were involved in any prehabilitation or cardiac rehabilitation programs.
Age and diabetes control in an HIV-endemic country: is there an association?
Published in Journal of Endocrinology, Metabolism and Diabetes of South Africa, 2022
It is well established that there is an association between hypertension and cardiovascular disease (CVD), commonly resulting in increased mortality.26 PLWD have a 200–400% risk of dying from CVD,27 while some estimate that it can be as high as 10 times the risk of the general population.28 In patients with hypertension and DM, the CVD risk increases by a further 75%.29 In our study, systolic hypertension was positively associated with age. This is similar to what has been shown in other studies globally. An American study conducted by Ostchega et al. highlighted the increased prevalence of hypertension with age.30 In contrast to this, our study found that the mean age of patients with increased DBP ≥ 90 mmHg was younger than those with a DBP < 90 mmHg. According to Li et al., DBP is an important risk factor for coronary disease in younger patients.31 It has also been shown to be a risk factor for formation of an abdominal aortic aneurysm.32 Clinicians should be aware of this risk factor and pay special attention to diastolic blood pressures just as much in the younger PLWD as they do for older patients. In SA, Steyn et al. highlighted that the care of patients with DM and hypertension is suboptimal.33 Strained healthcare systems are a major challenge, especially in Africa, with only 2% of patients having good control of hypertension.34 It is therefore important to implement effective early interventions to manage non-communicable diseases such as DM and HPT, especially when they coexist.