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Cardiology
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
Breathlessness that may occur on exertion, at rest, lying flat (orthopnoea), nocturnal cough or waking from sleep gasping for breath (paroxysmal nocturnal dyspnoea). Patients may also produce white/pink frothy sputum
Chronic heart failure
Published in Swati Gupta, Alexandra Marsh, David Dunleavy, Kevin Channer, Cardiology and the Cardiovascular System on the move, 2015
Swati Gupta, Alexandra Marsh, David Dunleavy, Kevin Channer
SymptomsDyspnoeaOrthopnoea – dyspnoea when lying flatParoxysmal nocturnal dyspnoea – sudden breathlessness disrupting sleepNocturnal cough and wheezeFatigue
Clinical management
Published in Alistair Burns, Michael A Horan, John E Clague, Gillian McLean, Geriatric Medicine for Old-Age Psychiatrists, 2005
Alistair Burns, Michael A Horan, John E Clague, Gillian McLean
The principal symptoms are breathlessness with exercise limitation and fluid retention. Patients may report orthopnoea - breathlessness when lying f�at when heart failure is severe. Paroxysmal nocturnal dyspnoea is an acute episode of breathlessness at night, and is seen particularly in acute left ventricular failure. Patients may notice ankle swelling and weight gain. Elderly patients may present quite late because patients may not notice symptoms due to their limited exercise capacity. Examination may reveal ankle oede- ma or sacral oedema if the patient has been bed-ridden. The jugular venous pressure (JVP) may be raised. The apex beat may be displaced. An added third heart .sound may be heard, and bibasal fine inspiratory crackles may be heard on chest auscultation. Hepatomegaly may be seen due to hepatic congesti�n.
Increased frequency of occurrence of bendopnea is associated with poor outcomes in heart failure outpatients
Published in Acta Cardiologica, 2021
Hakkı Kaya, Anıl Şahin, Hakan Güneş, Lütfü Bekar, Ahmet Çelik, Yüksel Çavuşoğlu, Vedat Çaldır, Hasan Güngör, Mehmet Birhan Yılmaz
Shortness of breath is the most basic symptom in HF patients, and subtypes such as exercise dyspnoea, orthopnea, paroxysmal nocturnal dyspnoea have long been considered as HF symptoms [3]. A new symptom, called bendopnea, was introduced by Thibodeau et al., which was described as shortness of breath within the first 30 sec. after leaning forward [4]. Thibodeau et al. also associated bendopnea with increased filling pressures, and then their subsequent research associated bendopnea with poor outcomes in HF outpatients [5]. HF course is a dynamic process for pathophysiological reasons. Symptoms such as orthopnea, paroxysmal nocturnal dyspnoea, and bendopnea, which are particularly related to increased filling pressures, may appear and disappear from time to time in HF patients due to the variable course of filling pressures [6–8]. In this study, we aimed to evaluate the relationship between the frequency of occurrence of bendopnea and long-term prognosis in HF outpatients, for the first time in the literature.
Management of valvular heart disease in the pregnant patient
Published in Expert Review of Cardiovascular Therapy, 2020
Mitral valve stenosis (MS) is the most commonly encountered stenotic valvular lesion during pregnancy [7]. When present, it is caused in most cases by rheumatic heart disease [8]. It is particularly poorly tolerated during pregnancy given the increase in the pressure gradient between the left atrial and left ventricle secondary to hemodynamic changes of pregnancy. Clinically, it results in dyspnea, decreased exercise capacity, orthopnea, and paroxysmal nocturnal dyspnea. Additionally, secondary to an increase in LA pressure, there is an increased risk of atrial arrhythmias, particularly atrial fibrillation, which leads to further hemodynamic decompensation and palpitations.
For the love of muscles: a bodybuilder with complicated left ventricular heart failure
Published in Acta Cardiologica, 2022
Lidwina De Turck, Tom Sarens, Laurens Veldeman, An Vonck
A 46-year-old Caucasian male bodybuilder presented at the emergency department with complaints of severe dyspnoea, orthopnoea, abdominal pain, oedema and numbness of the lower limbs, which started six weeks ago. The patient had deliberately postponed clinical evaluation due to the current COVID-19 pandemic. Eventually, because of severe paroxysmal nocturnal dyspnoea, he sought medical advice. He admitted to a 12-year history of routine intramuscular and oral administration of AAS (a combination of nandrolone, testosterone, methandienone).