China
Africa
Explore chapters and articles related to this topic
Ventricular Assistance as a Bridge to Cardiac Transplantation
Published in Wayne E. Richenbacher, Mechanical Circulatory Support, 2020
The primary indication for use of a VAD as a bridge to transplantation is in a HHI patient who fulfills cardiac transplantation selection criteria but who fails hemodynamically prior to the availability of a donor heart (Table 6.1). Patients with advanced congestive heart failure present with increased shortness of breath, dyspnea on exertion, paroxysmal nocturnal dyspnea, complaints of lethargy and easy fatigability. Physical Findings include jugulovenous distention and peripheral edema. Cardiomegaly is manifest by lateral displacement of the palpated point of maximal impulse and pulmonary congestion on chest auscultation. Decreased breath sounds at the lung bases may indicate the presence of pleural effusions. Patients with advanced right heart failure develop abdominal distention with ascites and a palpable fluid wave. The liver edge may be palpated below the right costal margin. End stage right heart failure is manifest by a pulsatile liver margin. Laboratory abnormalities document the severity of the congestive heart failure. Fluid retention associated with congestive heart failure is accompanied by hyponatremia with serum sodium levels falling below 125–130 mEq/L. The low output state associated with advanced congestive heart failure leads to end organ dysfunction. End organ hypoperfusion is manifest by an elevation in serum urea nitrogen (BUN) and creatinine as well as a rise in liver function tests. Hepatic congestion secondary to central venous hypertension also leads to derangements of the clotting cascade including a prolongation in the prothrombin time.
Central Blood Pressure
Published in Giuseppe Mancia, Guido Grassi, Konstantinos P. Tsioufis, Anna F. Dominiczak, Enrico Agabiti Rosei, Manual of Hypertension of the European Society of Hypertension, 2019
Stéphane Laurent, Cristina Giannattasio
A large number of publications and several reviews (4,5,10,13,20) reported the changes in central BP and wave reflections after various pharmacological treatments. Pharmacological treatments which are able to reduce central BP and wave reflections include (a) all antihypertensive treatments, such as diuretics, beta-blockers, ACE inhibitors, angiotensin II receptor blockers (ARBs) and calcium channel blockers (CCBs); (b) treatments of congestive heart failure, such as ACE inhibitors, nitrates and aldosterone antagonists; and (c) advanced glycation end-product (AGE)-breakers, such as alagebrium (ALT-711).
Congenital heart disease
Published in Clive Handler, Gerry Coghlan, Nick Brown, Management of Cardiac Problems in Primary Care, 2018
Clive Handler, Gerry Coghlan, Nick Brown
Complications of Eisenmenger’s syndrome include bleeding disorders, atrial fibrillation, syncope, stroke, transient ischaemic attacks, renal dysfunction and angina. Such complications usually affect patients after the age of 30 years. Congestive heart failure is a serious, usually end-stage complication that occurs in patients in their forties. Around 40% of patients survive into their forties. Most patients die suddenly as a result of a sudden fall in cardiac output, which may be induced by ventricular fibrillation related to hypoxia.
Feasibility of home-based cardiac rehabilitation in frail older patients: a clinical perspective
Published in Physiotherapy Theory and Practice, 2023
Michel Terbraak, Lotte Verweij, Patricia Jepma, Bianca Buurman, Harald Jørstad, Wilma Scholte Op Reimer, Marike van der Schaaf
The average age of patients in the observed treatment sessions was 81 ± 8.2 years, of which five were males (Table 2). The majority of the patients had at least two geriatric conditions out of: 1) limitations in Activities of Daily Living (ADL); 2) falls; 3) malnutrition, and 4) risk of delirium according to the DSMS screening. All patients were diagnosed with congestive heart failure and the cause for hospital admissions were decompensated congestive heart failure (n = 5), endocarditis (n = 1), angina pectoris (n = 1), and pacemaker implantation (n = 1). The following comorbidities were reported – diabetes mellitus (n = 4), peripheral arterial disease (n = 2), chronic obstructive pulmonary disease (n = 1), knee osteoarthritis (n = 1), stroke (n = 1), and renal failure (n = 2).
Research progress in strategies to improve the efficacy and safety of doxorubicin for cancer chemotherapy
Published in Expert Review of Anticancer Therapy, 2021
Muhammad Sohail, Zheng Sun, Yanli Li, Xuejing Gu, Hui Xu
DOX and epirubicin are both antitumor drugs that have a broad antitumor spectrum. These antitumor drugs are well known to inhibit the formation of nucleic acid when they are being inserted into the DNA. However, with their enhanced antitumor spectrum, they have got some serious side effects [98]. The most common side effect is their high toxicity, including bone marrow toxicity, stomatitis, gastrointestinal diseases, alopecia, acute and cumulative cardiac toxicity (Figure 3). The toxicity of using these drugs can cause a sharp decrease of monocytes and platelet count in the bone marrow and blood [99]. In case of cardiac toxicity, it may lead to irreversible myocardial congestive heart failure. To address this problem, Liu et al patented (US9982011B2) the synthesized Legumain activated DOX derivative. The advantage of the derivative over simple doxorubicin is that it has a longer metabolic half-life and activates only at the tumor site, decreasing the toxicity and increasing the efficacy. The drug has been tested on different cancer cell lines (4T1, MDA-MB231, etc.), and the results are in good agreement with the statement of the inventor [100].
Association of lipoprotein (a) and in-hospital outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention
Published in Postgraduate Medicine, 2021
Baoquan Wu, Hanjun Zhao, Changhua Liu, Hao Lu, Ruishuang Liu, Juan Long, Zhiling Zhang, Fanfang Zeng
In-hospital cardiovascular events were identified and adjudicated by independent cardiologists who were not involved in the current study. All the cardiovascular events were adjudicated based on clinical symptoms/signs, laboratory tests, and imaging studies rather than based on ICD-9 code, and the cardiovascular events included acute stent thrombosis, myocardial infarction, ischemic stroke/TIA, congestive heart failure and cardiovascular mortality. In specific, acute stent thrombosis was diagnosed based on coronary angiography with evidence of thrombotic occlusion of the implanted coronary stent. Myocardial infarction was diagnosed based on clinical symptoms (e.g. substernal chest pain), electrocardiographic exam (e.g. ST-segment elevation or depression) and plasma concentration of cardiac troponin I above the 99th percentile upper normal limit. Patients with myocardial infarction due to acute stent thrombosis was defined as the event of acute stent thrombosis. Ischemic stroke/TIA was diagnosed based on neurologic deficits plus cerebrovascular imaging evidence (e.g. computed tomography). Congestive heart failure was diagnosed based on clinical symptoms (e.g. dyspnea) and signs (e.g. crackles in bilateral lung) and elevated NT-proBNP. Cardiovascular mortality was defined as death due to cardiac etiologies.