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Published in Justin C. Konje, Complete Revision Guide for MRCOG Part 2, 2019
B Dissecting aortic aneurysm ruptureThe typical features of dissecting aneurysm include sudden onset of severe chest or upper back pain often described as a tearing, ripping or shearing sensation that radiates to the neck or down the back a wide pulse pressure and systolic hypertension (if the patient is not already in shock). The pain tends to be central or interscapular and is often followed by sudden collapse. (Maternal Collapse in Pregnancy and the Puerperium. The Royal College of Obstetricians and Gynaecologists Green-top Guideline No. 56, February 2011)
Prognosis: Studies of disease course and outcomes
Published in Milos Jenicek, Foundations of Evidence-Based Medicine, 2019
Making a prognosis based simply on knowing how many patients will survive a certain time period (e.g. five years following the detection of a cancer or any other disease) would rely on very poor information since the exact timing (moment of occurrence) of the events in this five-year period would be ignored. As shown by Fletcher et al.,11 several diseases may show a comparable survival rate at a given moment, 10% for example. Such a prognosis can be made for a rapidly dissecting aortic aneurysm: Subjects mainly die within the first one or two years following its discovery. A similar five-year survival rate can be observed in chronic granulocytic leukemia, but more patients survive beyond the first year and years after within the same five-year period. Similarly, Figure 10.4 represents two survival curves for glioma patients.27
Systemic hypertension in the elderly
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
Wilbert S. Aronow, William H. Frishman
Hypertension in older persons is a major risk factor for coronary events (1–3,25–29), for stroke (1–3,25,29–32), for CHF (1–3,24,33,34), and for PAD (2,3,35–39). Hypertension is present in approximately 69% of patients with a first MI (19), in approximately 77% of patients with a first stroke (19), in approximately 74% of patients with CHF (19), and in 60% of patients with PAD (39). Hypertension is also a major risk factor for a dissecting aortic aneurysm, sudden cardiac death, angina pectoris, atrial fibrillation, DM, the metabolic syndrome, chronic kidney disease, thoracic and abdominal aortic aneurysms, LV hypertrophy, vascular dementia, Alzheimer’s disease, and ophthalmologic disorders (2,3).
Managing the elderly patient with hypertension: current strategies, challenges, and considerations
Published in Expert Review of Cardiovascular Therapy, 2020
Hypertension is the leading modifiable risk factor for cardiovascular events and mortality in the world [1]. Hypertension is a major risk factor for cardiovascular events and mortality in the elderly [2]. Hypertension is present in 69% of persons with a first myocardial infarction [3], in 77% of persons with a first stroke [3], in 74% of persons with congestive heart failure [3], and in 60% of older persons with peripheral arterial disease [4]. Hypertension is also a major risk factor for the development of sudden cardiac death, dissecting aortic aneurysm, angina pectoris, left ventricular hypertrophy, thoracic and abdominal aortic aneurysms, chronic kidney disease, atrial fibrillation, diabetes mellitus, the metabolic syndrome, vascular dementia, Alzheimer’s disease, and ophthalmologic disease [2]. A meta-analysis of 61 prospective studies including data from 1 million adults without prior cardiovascular disease showed that cardiovascular risk increases progressively from a blood pressure level of 115/75 mm Hg with a doubling of the incidence of coronary heart disease and of stroke for every 20/10 mm Hg increase [5]. This review article will discuss management of the elderly patient with hypertension: current strategies, challenges, and considerations.
Multiple intracranial aneurysms in a patient with type I Gaucher disease: a case report and literature review
Published in British Journal of Neurosurgery, 2020
Matthew R. Reynolds, Daniel M. Heiferman, Andrew B. Boucher, Brian M. Howard, Daniel L. Barrow, Jacques E. Dion
To date, there remains a paucity of literature to suggest that GD patients are more susceptible to the development of arterial aneurysms in either the systemic or intracerebral circulations. Splenic artery aneurysms have been reported in GD patients, but these were attributed to hypersplenism and splenomegaly causing vascular compression with resultant arterial hypertension. Additionally, Nasu and colleagues reported a GD patient with annulo-aortic ectasia and a dissecting aortic aneurysm.1 To our knowledge, however, there have been no prior reports of multiple UIAs in a patient with GD.
Effect of Hibiscus sabdariffa and Zingiber officinale on the antihypertensive activity and pharmacokinetic of losartan in hypertensive rats
Published in Xenobiotica, 2020
Abdul Ahad, Mohammad Raish, Yousef A. Bin Jardan, Mohd Aftab Alam, Abdullah M. Al-Mohizea, Fahad I. Al-Jenoobi
Hypertension (HTN) is the most common cardiovascular disease. It is defined as a sustained rise in blood pressure ≥140/90 mm Hg, that could be a leading cause of stroke and coronary artery disease, heart failure, renal failure, and dissecting aortic aneurysm (Ahad et al., 2017; Ahad et al., 2018a). It affects more than 72 million people in the United States and more than one billion people worldwide (Sharan et al., 2011).